Browsing by Subject "Death"
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Item Open Access Baudelaire's Responses to Death: (In)articulation, Mourning and Suicide(2012) Wu, JoyceAlthough Charles Baudelaire's poetry was censored in part for his graphic representations of death, for Baudelaire himself, death was the ultimate censorship. He grappled with its limitations of the possibility of articulation in Les Fleurs du mal, Le Spleen de Paris, "Le Poème du hachisch," and other works. The first chapter of this dissertation, "Dead Silent," explores Baudelaire's use of apophasis as a rhetorical tactic to thwart the censoring force of death as what prevents the speaking subject from responding. Chapter two, "Voices Beyond the Grave," then investigates the opposite poetics of articulation and inarticulation, in the form of post-mortem voice from within the cemetery, and particularly as didactic speech that contradicts the living. "Baudelaire's Widows" argues that the widow is for Baudelaire a figure of modernity par excellence, auguring the anticipation of mourning and the problem of remembering the dead as a lifelong cognitive dilemma. Chapter four, "Lethal Illusions," combines analysis of suicide in "La Corde" and "Le Poème du hachisch" with interrogation of mimesis. If the intoxicant serves as suicide and mirror, the production of illusion is the possibility and the fatal pathology of art. Yet art simultaneously channels a truth understood as the revelation of illusions--not least the illusion of a life without death.
Item Open Access Death is Nothing! A Defense of Epicureanism(2020) Burkhardt, TimDeath can be terrible for the survivors of the deceased, but can it be bad for the deceased themselves? Epicurus argued that it could not be, apparently because there is no temporal overlap between death and the deceased person—no time at which both are present. This argument has received a great deal of philosophical attention in recent decades, but few philosophers of death find it convincing. Most believe that death can be bad for the deceased and some fear that grave moral implications would follow if it could not be. This dissertation argues otherwise. It begins by defending Epicurus’ argument against a host of the most promising contemporary objections to it. Finding that these objections fail, it concludes that the prevailing philosophical consensus is unjustified: although death may be a great misfortune for the survivors of the deceased, it cannot be bad for the deceased themselves. The dissertation then examines the implications of this conclusion for some other issues in ethics, arguing that these implications are not as unpleasant as is sometimes believed. In doing so, it hopes to establish a foothold for the larger project of showing that Epicureanism, deeply important though it is, does not wreak havoc upon the moral landscape.
Item Embargo Death Work: Prison Chaplaincy, Karl Barth, and Practicing Life in Prison(2023) Jobe, Sarah C.This is a book about life-in-death work, what the Christian tradition has often called salvation or atonement. How does the life, arrest, trial, conviction, execution, and release from state-supervision of Jesus Christ enact the salvation of the cosmos. How does that one carceral life-in-death link up with life in the face of prison death today? I have sought to answer these questions by taking my body in and out of prison as a prison chaplain while conversing with other prison chaplains, theologian Karl Barth, and the biblical witness to Jesus Christ. In the tradition of theological ethnography, this work brings together theological and biblical reflection with data from a two-year, collaborative ethnography on current and former prison chaplains. This is the first nation-wide study of prison chaplaincy based on an interview protocol rather than a survey, and it provides a wealth of narratives on the complexities of prison chaplaincy, an understudied profession. Karl Barth serves as a conversation partner throughout because he enters the witness box as one who knows and writes the incarcerated Christ, has been arrested and convicted himself, and practiced prison chaplaincy as a volunteer chaplain at Basel Prison from 1954-1964.As a practical soteriology, this work describes how prison chaplains follow the arc of Jesus’ life and work. Chaplains follow Jesus’ incarnation in their ministry of presence, embodying the way that Jesus’ prophetic work threatens social divisions and death-dealing authorities. They receive the same death-threats that Jesus received and bear the impact of prisons in their bodies, being made sin for the sake of salvation. They stand with Jesus and others in carceral death, and they participate in Jesus’ resurrected life-after-death, sometimes while still in prison and sometimes having been freed from it. The architecture of this book follows that story line – the arc of Jesus’ incarnation, prophetic ministry, arrest, death, and resurrection – what Christians confess to be the arc of salvation. That salvific scaffolding is then filled up with the narratives of chaplains – historically, from within this study, and from my own professional experiences. The words of chaplains become the eyewitness accounts to life-in-death work, i.e., to the texture of salvation.
Item Open Access Deaths in triathletes: immersion pulmonary oedema as a possible cause.(BMJ Open Sport Exerc Med, 2016) Moon, Richard E; Martina, Stefanie D; Peacher, Dionne F; Kraus, William EBACKGROUND/AIM: To address the question as to whether immersion pulmonary oedema (IPO) may be a common cause of death in triathlons, markers of swimming-induced pulmonary oedema (SIPO) susceptibility were sought in triathletes' postmortem examinations. METHODS: Deaths while training for or during triathlon events in the USA and Canada from October 2008 to November 2015 were identified, and postmortem reports requested. We assessed obvious causes of death; the prevalence of left ventricular hypertrophy (LVH); comparison with healthy triathletes. RESULTS: We identified 58 deaths during the time period of the review, 42 (72.4%) of which occurred during a swim. Of these, 23 postmortem reports were obtained. Five individuals had significant (≥70%) coronary artery narrowing; one each had coronary stents; retroperitoneal haemorrhage; or aortic dissection. 9 of 20 (45%) with reported heart mass exceeded 95th centile values. LV free wall and septal thickness were reported in 14 and 9 cases, respectively; of these, 6 (42.9%) and 4 (44.4%) cases exceeded normal values. 6 of 15 individuals (40%) without an obvious cause of death had excessive heart mass. The proportion of individuals with LVH exceeded the prevalence in the general triathlete population. CONCLUSIONS: LVH-a marker of SIPO susceptibility-was present in a greater than the expected proportion of triathletes who died during the swim portion. We propose that IPO may be a significant aetiology of death during the swimming phase in triathletes. The importance of testing for LVH in triathletes as a predictor of adverse outcomes should be explored further.Item Open Access Incidence of Postreperfusion Hyperfibrinolysis in Liver Transplantation by Donor Type and Observed Treatment Strategies.(Anesthesia and analgesia, 2023-03) Krom, Russell J; Welsby, Ian J; Fuller, Matthew; Barbas, Andrew S; Gao, Qimeng; Anwar, Imran J; Dunkman, W JonathanBackground
Hyperfibrinolysis is a possible complication during liver transplantation, particularly immediately after reperfusion.Methods
We performed a retrospective study to examine the incidence, treatment, and resolution of postreperfusion hyperfibrinolysis in patients undergoing liver transplantation at Duke University Hospital from 2015 to 2020.Results
Out of 535 patients undergoing liver transplantation, 21 or 3.9%, 95% CI (2.5-5.9), had hyperfibrinolysis after reperfusion. Hyperfibrinolysis occurred in 16 of 511 (3.1%) patients receiving livers from DBD donors, 5 of 18 (27.8%) patients receiving livers from donation after circulatory death (DCD) donors, and 0 of 6 (0.0%) patients receiving livers from living donors. Fibrinolysis was treated with cryoprecipitate (12/21), a combination of cryoprecipitate and tranexamic acid (3/21), or neither (6/21) and resolved within several hours in all cases.Conclusions
Anesthesiologists should be aware of the possibility of postreperfusion hyperfibrinolysis in liver transplantation, particularly with DCD donors, and may consider treatment with cryoprecipitate or tranexamic acid. Further work is needed to identify any potential differences, such as faster resolution of fibrinolysis, between different treatment modalities.Item Open Access Living Life in the Face of Death: An Ethnographic Exploration of Healing, Temporality, and Connection in Suicide(2024) Sperber, BenjaminSuicidality is a visceral, frightening reality that many with mental illness face on a daily basis. Treated with contempt in society, much of the scholarship surrounding suicidality focuses on the family or the effectiveness of treatment options. This thesis represents an effort to hold space for those who suffer from suicidality. Through ethnographic research on reddit and through semi-structured interviews with those who have been involuntarily committed in the state of North Carolina, the author offers a new analysis of the contingencies of healing, time, and connection for those who fail in their aimed desire of death through suicide. Split into three chapters, the author first examines how western biomedicine and the telos of medicine (i.e., treating to cure) necessarily is complicated by mental illness, leaving those who experience suicidality to feel that they are incapable of healing. Moreover, the author undertakes an exploration of differing tropes within biomedicine in an attempt to shed light on how dominant notions of healing are confounded or complicated by suicidality. In Chapter Two, the author explores time; namely, how suicidality subverts productivity-centered, future-oriented understandings and experiences of time. To this end, the author poses a new temporal schema, suicidal temporality, which seeks to explain how those who fail at suicide attempts experience time, the accumulation of life stressors, administrative labor, and more. In the final chapter, the author explores two forms of relationships—those between patient and physician, as well as those between suicidal individuals—to demonstrate how differing contexts can afford or limit a suicidal person varying levels of connection, trust, and aid from their interlocutor. Offering no solutions to eradicate suicidality, the author instead hopes to allow readers to gain a greater understanding of the experiences, emotions, and sensorial experiences that accompany suicidality.Item Open Access Misrecognized: Looking at Images of Black Suffering and Death(2008-04-30) Baker, Courtney RThis dissertation investigates the social, emotional, and ethical implications of looking at the suffering and death of African Americans. Drawing on film theory, visual studies, literary criticism, and semiotics, the study addresses events and images from 1834 to 2000 in which the humanity of the black body was called into question. The events discussed include: a nineteenth-century riot over the abuse of slaves; the mass media depiction of Hurricane Katrina survivors; the National Association for the Advancement of Colored People's 1935 antilynching art exhibition; James Allen's 2000 exhibition of lynching photography; the Emmett Till case; and the Spike Lee-directed film Bamboozled (2000). The project ultimately argues for a nuanced appreciation of looking relations that takes into account the ethics of the look, especially when that look is directed toward bodies that cannot speak for and in defense of themselves.
Item Open Access Muscle Mass Assessed by the D3-Creatine Dilution Method and Incident Self-reported Disability and Mortality in a Prospective Observational Study of Community-Dwelling Older Men.(The journals of gerontology. Series A, Biological sciences and medical sciences, 2021-01) Cawthon, Peggy M; Blackwell, Terri; Cummings, Steven R; Orwoll, Eric S; Duchowny, Kate A; Kado, Deborah M; Stone, Katie L; Ensrud, Kristine E; Cauley, Jane A; Evans, William JBackground
Whether low muscle mass is a risk factor for disability and mortality is unclear. Associations between approximations of muscle mass (including lean mass from dual-energy x-ray absorptiometry [DXA]), and these outcomes are inconsistent.Methods
Muscle mass measured by deuterated creatine (D3Cr) dilution and appendicular lean mass (ALM, by DXA) were assessed at the Year 14 Visit (2014-2016) of the prospective Osteoporotic Fractures in Men study (N = 1,425, age 77-101 years). Disability in activities of daily living (ADLs), instrumental ADLs, and mobility tasks was self-reported at the Year 14 visit and 2.2 years later; deaths were centrally adjudicated over 3.3 years. Relative risks and 95% confidence intervals (CI) were estimated per standard deviation decrement with negative binomial, logistic regression, or proportional hazards models.Results
In age- and clinical center-adjusted models, the relative risks per decrement in D3Cr muscle mass/wgt was 1.9 (95% CI: 1.2, 3.1) for incident self-reported ADL disability; 1.5 (95% CI: 1.3, 1.9) for instrumental ADL disability; and 1.8 (95% CI: 1.5, 2.2) for mobility disability. In age-, clinical center-, and weight-adjusted models, the relative risks per decrement in D3Cr muscle mass was 1.8 (95% CI: 1.5, 2.2) for all-cause mortality. In contrast, lower DXA ALM was not associated with any outcome. Associations of D3Cr muscle mass with these outcomes were slightly attenuated after adjustment for confounding factors and the potentially mediating effects of strength and physical performance.Conclusions
Low muscle mass as measured by D3Cr dilution is a novel risk factor for clinically meaningful outcomes in older men.Item Open Access Reclaiming the Tradition of Prophetic Proclamation in the Black Church: The Significance of Proclaiming Life in the Face of Death(2023) Jones, Calvon TijuanOut of the crucible of racism, pain, dehumanization, subjugation, marginalization, discrimination, enslavement, and death inflicted upon Black bodies, Black persons responded with a hermeneutic of freedom and prophetic proclamation in the North American context. Amidst a death-dealing system of oppression and chattel slavery, Black persons through proclamation—sermons, stories, songs, spirituals, modes of worship, words, lived experiences, and embodied acts of resistance—utilized their faith to challenge the heresy of white supremacy. Black religion and spirituality were conceived and birthed in response to existential pain, suffering and death. Black religion and the Black Church were rooted in a proclamation that not only utilized Christianity in the West, but also refashioned it in order to liberate the mind, body, and soul of Black people from the pangs of unwarranted death – prophetic proclamation.
Undoubtedly, today, in a nation that is scorched by hate, systemic oppression, and injustice, the Black Church of the 21st century is in dire need to recover its ministry of prophetic proclamation in the face of death and evil powers. Although the Black Church’s conception is formed out of prophetic proclamation and resistance to perpetual crisis and death, a number of Black congregations have forgotten the history and tradition of the Black Church. Messages of prosperity have seemingly replaced prophetic proclamation. In this project, I suggest that the survival of the Black Church hangs on the tradition of prophetic proclamation. I suggest that the Black Church will only survive if its mission and ministry are rooted in addressing and responding to the pervasive reality of death inflicted upon Black bodies through varying forms of prophetic proclamation as seen through resistance in the Middle Passage to the modern-day Black Lives Matter Movement.
Given the monumental changes brought about by the global COVID-19 pandemic of 2020, and the continual and perpetual threat of death and oppression upon the Black body in today’s society, the Black Church has been forced to explore ‘church’ in a different way – beyond the four walls of a church building. This new reality shows the Black Church that we must embrace the fluidity and intricacy of proclamation which moves from traditional, pulpit-centered discourse to diverse, enlivened, and embodied discourse which will ultimately transform the lives of Black peoples.
Item Open Access The Impact of Time, Region, and Income Level on Stillbirth and Neonatal Mortality(2022) Rent, SharlaBackground: Neonatal mortality and stillbirth remain prominent global health issues. The majority of these perinatal losses occur in low- and middle-income countries and are related to lack of quality care around delivery. Brazil transitioned from a lower-middle income country to an upper-middle income country in 2006 and has over 95% of its births occurring within the health system. Methods: We conducted a longitudinal, ecological cohort study based on publicly available data from the Brazilian Ministry of health’s data repository on live births and deaths. Data was analyzed at the municipality level from 2000 to 2019. Records from the Atlas of Human Development in Brazil were then used to associate each region with a World Bank income classification. Results: National neonatal mortality rate decreased from 21.2 in 2000 to 12.4 in 2019. Stillbirth rate decreased from 12.0 to 10.2 over this time. Rates were lower when infants born before 28 weeks gestation were excluded. For infants born between 22- and 27-weeks’ gestation, worsening perinatal outcomes were seen after 2012. Municipalities with higher wealth status have lower stillbirth and neonatal mortality rates across all years of the study. Conclusion: Brazil has made significant progress in neonatal mortality and stillbirth rates from 2000 to 2019, yet inequity in perinatal outcomes remains across the country and is correlated with economic status. Nationally, ongoing improvement is needed for infants below 28 weeks gestation and closer exploration is needed into why there are increasing rates of negative perinatal outcomes amongst infants 22-27 weeks gestation.
Item Open Access The Wages of Sin: A Grammatical Theology of Death(2020) Porter, Philip GregoryThis dissertation investigates the origins of death. It does so by drawing on Augustine of Hippo’s theology of creation, especially as expressed in his De Genesi ad litteram. It argues that recovering Augustine’s theory of the rationes seminales as presented in De Genesi ad litteram is a useful tool that allows contemporary theology to engage with modern cosmology and evolutionary biology without compromising on Catholic magisterial teaching regarding the connection between sin and death. The work consists of five chapters, plus an introduction and conclusion.
The first chapter is methodological. It explains how one might read the text of Genesis ad litteram in the sense Augustine uses the term. To do this, it draws on the resources of Ordinary Language Philosophy. Chapter two investigates Augustine’s use of the term ‘rationes seminales’ and provides a speculative account of what they are. Chapter three connects the speculations on the rationes seminales to the fall of the angels, examining scriptural and doctrinal evidences concerning the nature of the demons. Chapter four remains focused on the angelic fall, but from a literary perspective. It uses Shakespeare’s Troilus and Cressida and Milton’s Paradise Lost to flesh out a theology of angels, their fall, and the effects this has on the created order. The last chapter examines how the effects of the angelic fall play out in time. It connects the speculations about the angelic fall to the human fall, showing how the doctrine of original sin as taught by the Catholic magisterium is compatible with discoveries in evolutionary biology and modern cosmology.
Item Open Access The Wages of Sin: A Grammatical Theology of Death(2020) Porter, Philip GregoryThis dissertation investigates the origins of death. It does so by drawing on Augustine of Hippo’s theology of creation, especially as expressed in his De Genesi ad litteram. It argues that recovering Augustine’s theory of the rationes seminales as presented in De Genesi ad litteram is a useful tool that allows contemporary theology to engage with modern cosmology and evolutionary biology without compromising on Catholic magisterial teaching regarding the connection between sin and death. The work consists of five chapters, plus an introduction and conclusion.
The first chapter is methodological. It explains how one might read the text of Genesis ad litteram in the sense Augustine uses the term. To do this, it draws on the resources of Ordinary Language Philosophy. Chapter two investigates Augustine’s use of the term ‘rationes seminales’ and provides a speculative account of what they are. Chapter three connects the speculations on the rationes seminales to the fall of the angels, examining scriptural and doctrinal evidences concerning the nature of the demons. Chapter four remains focused on the angelic fall, but from a literary perspective. It uses Shakespeare’s Troilus and Cressida and Milton’s Paradise Lost to flesh out a theology of angels, their fall, and the effects this has on the created order. The last chapter examines how the effects of the angelic fall play out in time. It connects the speculations about the angelic fall to the human fall, showing how the doctrine of original sin as taught by the Catholic magisterium is compatible with discoveries in evolutionary biology and modern cosmology.
Item Open Access The Weight of Mortality: Pauline Theology and the Problem of Death(2019) Longarino, Joseph FrancisThis dissertation addresses a long-standing but rarely discussed problem in Pauline studies: given Paul’s understanding of how God has acted in Jesus Christ and the Holy Spirit to overcome death, how do we explain the ongoing existence of death? Through an examination of the Pauline letters, particularly Romans, this dissertation offers two interrelated explanations, one causal and the other teleological or purposive. From the causal perspective, it is argued that sin in the form of the sinful passions remains connected to the body even of Christians, which allows sin to exercise an ongoing corrupting influence on the body. From the teleological or purposive angle, it is contended that God uses the mortal condition to deepen the divine-human and intrahuman relationships.
Item Open Access What constitutes quality of family experience at the end of life? Perspectives from family members of patients who died in the hospital.(Palliative & supportive care, 2015-08) Steinhauser, Karen E; Voils, Corrine I; Bosworth, Hayden; Tulsky, James AMost palliative care efforts focus on assessing and improving the quality of life and quality of care for patients. Palliative care views the family as the unit of care; therefore, excellent comprehensive palliative care should also address the needs of the family and the caregiver(s). While the recent literature has offered detailed descriptions of caregiving needs in the home setting, it is crucial to describe the needs of family members who provide care for patients with advanced illness in an inpatient setting, where family members serve as the key intermediaries and decision makers. Therefore, we sought to define the relevant aspects of quality of experience for families of hospitalized patients.We convened a series of focus groups to identify the domains important for the quality of experience of dying patients' family members. Participants included bereaved family members of patients who had died at a Veterans Administration (VA) or private academic medical center. We conducted four in-depth follow-up interviews to probe for additional details and validate our interpretation of the focus group findings.Participants (n = 14) ranged in age from 46 to 83, with a mean of 62. All were female; 64% were Caucasian, 21% African American, and 14% did not report their ethnicity. Content analysis yielded 64 attributes of quality of family experience constituting eight domains: completion, symptom impact, decision making, preparation, relationship with healthcare providers, affirmation of the whole person, post-death care, and supportive services.Our data have implications for clinical guidance in assisting family members in the inpatient palliative setting, which often includes patient incapacity for communication and decision making. They suggest the importance of developing corresponding methods to assist families with the tasks involved with life completion, being prepared for a crisis and imminent death, and post-death care. Provider communications and relationships are central to the processes of meeting the clinical needs of family members. Our findings should inform the development of measures to assess family experience.