Large Societies Research Articles

A Society Can Always Decide How to Decide: A Proof

Infinite regress lies within every democratic procedural choice. If society members try to select an appropriate rule [social choice correspondence (SCC)] entirely endogenously, they will need an appropriate rule to choose such a rule. However, this should also be selected by an appropriate rule to choose a rule to choose a rule, and so on. This paper explores how to solve this infinite regress. A preference profile over the set of alternatives is said to converge if, at a sufficiently high level, every feasible SCC in the menu ultimately results in the same alternative, and hence, further regress has no effective meaning. A menu is said to be convergent if all preference profiles converge under the menu (i.e., infinite regress can “always” be resolved). First, we characterize the convergent menus under a special case. Then, we prove two general possibility theorems: (1) there exists a menu of SCCs that is strongly convergent (i.e., the outcome is uniquely determined); (2) any set of scoring rules can be extended to a superset that is asymptotically convergent for a large society (i.e., the probability of a convergent profile occurring goes to one as the population goes to infinity). Therefore, such a large society can “almost always” resolve the infinite regress by adding multiple SCCs. These theorems are expected to build new ground for SCCs in a distinct way from the axiomatic characterizations of standard social choice theory.

Effects of Non-physician Practitioners on Emergency Medicine Physician Resident Education.

The effects of non-physician practitioners (NPP) such as physician assistants and nurse practitioners on the education of emergency medicine (EM) residents have not previously been specifically evaluated. Emergency medicine societies have made policy statements regarding NPP presence in EM residencies without the benefit of empiric studies. A cross-sectional, mixed methods questionnaire with strong validity evidence was distributed to current EM residents who were members of a large national society, the American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA), between June 4-July 5, 2021. We received 393 partial and complete responses, representing a 34% response rate. A majority of respondents (66.9%) reported that NPPs have a detracting or greatly detracting impact on their education overall. The workload in the emergency department was reported generally as lighter (45.2%) to no impact (40.1%), which was cited in narrative responses as an aspect of both enhancing and detracting from resident physician education. Non-physician practitioner postgraduate programs in EM were associated with a 14x increase in the median number of procedures forfeited over the course of the prior year (median = 7.0 vs 0.5, P<.001). Among respondents, 33.5% reported feeling "not confident at all" in their ability to report concerns about NPPs to local leadership without retribution, and 65.2% reported feeling "not confident at all" regarding confidence in the Accreditation Council for Graduate Medical Education to satisfactorily address concerns about NPPs raised in the end-of-year survey. Resident members of the AAEM/RSA reported having concerns about the effects of NPPs on their education and their confidence in being able to address the concerns.

Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan

ObjectivesWe aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic.DesignCross-sectional online survey.SettingCommunity cohort study in Japan.ParticipantsThe second wave of a large web-based survey,...

KNOWLEDGE, ATTITUDE AND PRACTICE OF CANCER SCREENING AMONG DOCTORS IN THE UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL

Background:The number of working doctors in Nigeria has continued to drop owing to increasing cancer related morbidity and mortality. Objective: To determine the knowledge, attitude and practice of cancer screening among doctors at theUniversity of Port Harcourt Teaching Hospital (UPTH), Nigeria. Methodology: Structured questionnaire with closed and open ended questions were randomly distributed to Resident doctors and Consultants at UPTH. Respondents socio-demographic characteristics and knowledge, attitude and practice of cancer screening were assessed. Data was analyzed using the IBM statistical package for social sciences (SPSS) version 23. Results:Of the216respondents - 62.5% were Residents while 37.5% were Honorary Consultants peak age range was31-40 years with 46.3%. Males constituted 51.9% while females constituted 48.1%. Forty-four percent had spent 1-5 years in their current positions. Knowledge of canceramong the respondents was good as 83.3% of the doctors choose the option that cancer is an uncontrollable abnormal cell growth while 95.8% responded that there was no age restriction to cancer.While78.3% would seek immediate treatment if diagnosed with cancer,82.4% favored cancer screening. Poor practice of cancer screening was observed with 58.3% reporting they have never been screened for any type of cancers. Notably, 89.8% of them reported that the Government was not doing enough for cancer patients in the country. Conclusion:The study demonstrated good knowledge of cancer screening, positive attitude towards screening but poor practice of cancer screening by practicing specialist doctors in UPTH. Given the influence of doctors in the large society, introspection among doctors and initiation of effective advocacy programs by umbrella bodies like the Nigerian Medical Association, Medical and Dental Consultants of Nigeria, National Association of Resident Doctors and Medical Women Association is imperative in order to improve the acceptance and practice of cancer screening among doctors and reduce the burden of cancer mortality being recorded among doctors and other health care professionals.

Patriarchal Culture, Sexual Violence, and Legal Protection for Women in Indonesia

Patriarchal culture cannot be separated from women's lives. Male domination over women has become a daily reality in many countries. Patriarchal culture assumes that women are "objects" and men are humans. In this case, men become subjects, and women as objects are regulated by men in various lines of life and culture. The impact of patriarchal culture is to place women who experience sexual violence in a worse position. At the level of the construction of a large Indonesian society that still uses a patriarchal paradigm, women are placed as second-class citizens. As a result, often the statements and reports from women are not heard. A further implication for women victims of sexual violence is that they are re-victimized by society, considered as the party that caused the violence. This article will raise two legal issues related to legal theory and law. The first legal issue in this paper is related to feminist legal theory based on the feminist view that in history, law is to perpetuate the position of women under the subordination of men. After discussing feminist legal theory, the author will discuss the second issue, namely law related to law enforcement in the field of sexual violence and its relation to feminist legal theory. Feminist legal theory is needed in building the basis of statutory norms (legal dogmatics) and the justice system to eliminate all forms of violence, especially sexual violence.

Women Representation in Anesthesiology Society Leadership Positions.

Although the number of women in medicine has increased, women remain underrepresented in leadership positions, specifically in medical societies. Specialty societies in medicine are influential in networking, career advancement, research and education opportunities, and providing awards and recognition. The goals of this study are to examine the representation of women in leadership positions in anesthesiology societies compared to women society members and women anesthesiologists and to analyze the trend in women society presidents over time. A list of anesthesiology societies was obtained from the American Society of Anesthesiology (ASA) website. Society leadership positions were obtained via the societies' websites. Gender was determined by images on the society website and images or pronouns on hospital websites and research databases. The percentage of women presidents, vice presidents/presidents-elect, secretaries/treasurers, board of directors/council members, and committee chairs was calculated. The percentage of women in society leadership positions was compared to the percentage of women society members when available, and the percentage of women anesthesiologists in the workforce (26%) using binomial difference of unpaired proportions tests. The trend of women presidents from 1980 to 2020 was analyzed using a Cochran-Armitage trend test. A total of 13 societies were included in this study. Overall, women held 32.6% (189/580) of leadership positions. 38.5% (5/13) of presidents, 17.6% (3/17) of presidents-elect/vice presidents, and 45% (9/20) of secretaries/treasurers were women. In addition, 30.0% (91/303) of board of directors/council members and 34.2% (90/263) of committee chairs were women. The percentage of women holding society leadership positions was significantly greater than the percentage of women anesthesiologists in the workforce ( P < .001), as was the percentage of women as committee chairs ( P = .003). The percentage of women society members was available for 9 of 13 societies (69%), and the percentage of women leaders was similar to the percentage of women society members ( P = .10). There was a significant difference in the percentage of women leaders between society size categories. Small societies had 32.9% (49/149) women leaders, medium had 39.4% (74/188) women leaders, and the single large society had 27.2% (66/243) ( P = .03). There were also significantly more women leaders in the Society of Cardiovascular Anesthesiologists (SCA) than there are women members ( P = .02). This study suggests that anesthesia societies may be more inclusive of women in leadership positions compared to other specialty societies. Although in anesthesiology, women remain underrepresented in academic leadership roles, there is a higher proportion of women in leadership roles in anesthesiology societies than proportion of women in the anesthesia workforce.

The categorical dichotomy Gemeinschaft/Gesellschaft in sociological classics: Tonnies - Weber - Freyer - Parsons

The article considers the history of the conceptual pair Gemeinschaft/Gesellschaft (community/society) used by classics of sociology to explain the fundamental difference of modern society from the previous forms of social life. The author emphasizes the popularity of these categories as identifying the temporally successive types of sociality: Gemeinschaft refers to the original form of traditional organic community, and Gesellschaft - to the mass urbanized society of the modern age. The article shows the structural relationship between the early sociological concepts and the philosophy of modern history as an analytical (self)description of modern societies. The article reconstructs the development of Ferdinand Tönnies’ views, who introduced the pair Gemeinschaft/Gesellschaft as an analytical tool for social theory and challenged the opposition of these two types of social integration by emphasizing their presence in every social interaction. The author briefly outlines Max Weber’s perception of this conceptual pair in the form of Vergemeinschaftung/Vergesellschaftung social relations as ideally-typically value-oriented and instrumentally rational. The article explains the drastic politicization of the Gemeinschaft semantics in inter-war Germany - the term became a marker of the social-political polarization. Then the author focuses on the differentiated theory of Gemeinschaft developed in Hans Freyer’s sociology and on the Nazis’ attempt to make this term a basis of their theory of homogeneous society. The article considers the reception of Tönnies’ categories in American sociology, especially by Talcott Parsons, and highlights his contribution to the theory of socialization and integration of large societies with small solidarity groups. The last part of the article emphasizes the significance of the conceptual pair for the theory of late modernity - its structure of social action consists of elements of both community and society.

Gender Conflict and its Effect on Women before and after the World War II

Purpose: Women and men are completing each other, this is nature, and the conflict of women and men is historical, they both have the right in living, enjoying and producing, humans love power naturally and always seek for their rights. Both men and women are struggling to stand and make remarkable things to show their abilities to each other and to take a role in life.&#x0D; The purpose of this article is to discuss this historical conflict between the two genders and show the effect of this conflict on women before and after World War II by discussing the A Room of One’s Own by Virginia Woolf and The Homecoming by Harold Pinter. There are many faces of this conflict but this article will discuss two of them, the educational and the sexual ones as they are the main two faces of this gender conflict.&#x0D; Methodology: The problem that has no name is in fact the rights of women, the role of women in society, and the conflict between gender equality. Women were killed, raped, left without education, abused only because of their gender, from birth her parents teach her not to ask about her rights or think of herself but to obey her husband, father and brother, just like a salve, educated women present threaten to the patriarchal society for this reason they insisted not to educate women to keep the power in men’s hand. Although women conditions were very hard and they needed a long time but they also could make some change (Doolittle n.p)&#x0D; After the end of the Second World War there were emerging issues concerning the role of women in the society, whether they should be part of the small society inside their homes or start working and engage with the large society outside. Such significant issues of women's role in the society escalated conventional notions of male and female roles and responsibilities in the society. The identity of women started developing and emerging as a topic started taking its role in the society. The role-played by women themselves in constructing these identities and the insights gained into the ambivalence of the female role in the 1950s, lead her to urge a re-evaluation of 'consensus' politics and a redefinition of what we mean by work (Shaw).&#x0D; Findings: After a long struggle through decades asking about their rights women had a great role in the civil society in the 1950s. In the Second World War they found themselves in front of a big challenge, either they survive and defend their homes, country and families, or they lose them. Women start filling the missing part of men who went to war. They involved in different sectors, Industry, Agriculture, Army and others to stand up for the country. After the war ends women tried hard to keep their jobs but many of them were forced by men to leave their jobs and go back home that the society did not give the role of woman the value it deserves (History At a Glance: Women in World War II).&#x0D; Unique Contribution to Theory, Practice and Policy: The study presented a highly negative image of the society and ignored the presence of virtue and ethics in both American and English societies, which resulted in an unrealistic and flawed depiction of both men, and women in that era. Therefore its recommended that more studies should be done to resolve the conflict of gender roles and dominance in the society.

The “wall of text” visual structure of academic conference posters

Posters created for conferences are a type of visual communication that are used frequently by academics. There are rarely any formatting requirements beyond fitting on their provided boards. Because posters are usually created by researchers rather than experienced graphic designers, the visual structure of conference posters may be influenced by the common format for journal articles, where text is given primacy over graphics and structured as “introduction, methods, results, discussion.” To test this, I examined award-winning posters from a large scientific society over 5 years of meetings. About three-quarters use the “Introduction, methods, results, discussion” format common to journal articles; about two-thirds use a columnar layout; most show multiple graphs and cite multiple references. Relatively few posters follow best graphic design practices, resulting in a “wall of text” on many posters.

The classical liberal version of labor law: Beware of coercion dressed up as liberty

Abstract In this Article, I contest on both theoretical and empirical grounds the progressive agenda, as represented by Hanoch Dagan, that seeks to advance the unionization movement in the name of individual autonomy and property. Theoretically, the Article shows that the common-law account of autonomy, which stresses freedom of action from external constraints involving the use or threat of force, provides the best analytical framework, one that undermines the modern progressive case for collective bargaining by workers. The negative account of autonomy applies to all persons; its correlative duties are simple. It applies regardless of the overall level or distribution of wealth. It is scalable from small to large societies. And it forces employers to respect the full range of material and psychological needs in order to recruit and retain their workers. In contrast, the modern progressive alternative imposes no clear correlative duties on employers. It has no obvious way to constrain the dominance of union forces. And its commands are sufficiently complex that they are often not understood by the workers whom they are intended to protect. Empirically, this Article shows that the institutional rigidity of union structures in dynamic markets fails; and it rejects the claim that individual workers are wedded to their current employer, given competitive forces that allow for rapid entry and exit. Given the long-term systematic advantages of the classical liberal model, it is no surprise that unions are generally in decline in major industrial societies.

Ibn Khaldun’s Thoughts on Religion as A Personal Experience and A Social System

Dialogue and discussion about religion requires a cautious attitude. Because even though religion has a social function, its appreciation is very individual. Religion is the deepest part of a person's personality. The essential reality of religion is a special experience which expresses itself in symbols and seeks its intellectual expression in the science of kalam. Ibn Khaldun's concept of God is the beginning of the world's existence and theological phenomena. This is what equates ibn Khaldun with Muslim philosophers and scholastic theologians. Ibn Khaldul is firm about the relationship between man and his God because it is the law of causality. The creation process occurs because of the creation of the Absolute. It also rejects secondary causality, that all occurs in the world the elements come from the initiative or direct power of God. Similarly, there is no need to rationally prove God. Because absolute things in religion cannot be proven rationally. because the truth has been guaranteed by Allah's revelation. But this does not mean ignores reason, or autonomous thinking. According to him, sense is very precise and careful scale, innovative and reliable for the results. But in relation to the attribut of God, the role of reason is very limited. Ibn Khaldun's concept of religion as social legitimacy, that religion an important role that has the power of reconciliation, unifying, and unifying a large society. he projected on nomadic society, which was an unruly nation. But when religion comes to them, they submit to the rules created by religion, so something of solidarity is realized. Thus, he saw that religion could add political power, and his enthusiasm could accelerate the movement of history. however, religion needs an 'ashabiyyah foundation to be able to exert its influence. Between 'ashabiyyah and religion there is a dialectical relationship that cannot be contradicted. 'Ashabiyyah supported by religion is the most powerful politics. And religion without the 'ashabiyyah foundation will not be able to exert its influence

Free riding in networks

Players allocate their budgets to links, a local public good, and a private good. A player links in order to free ride on public good provided by others. We derive sufficient conditions for the existence of a Nash equilibrium, in which large contributors link to each other, while others link to them. If linking costs are sufficiently high, poorer players may contribute more and have more central positions in the network than richer ones do. In large societies, free riding reduces inequality only in networks in which it is initially low. Otherwise, richer players free ride more, as they can afford more links. Finally, we derive the policy implications for income redistribution.

Materialism, life satisfaction and Compulsive Buying Behavior: An empirical investigation on Egyptian consumers amid Covid‑19 pandemic

As part of transformative consumer research, which attempts to achieve effective ways to improve people lives, this research focuses are on comprehending the issue of materialism, especially during the Covid-19 crisis. Few studies deal with materialism within the setting of developing nations, especially in a large populated consumer society like Egypt in the Arab region. For this purpose, this research adds to the prevailing literature on materialism through proposing and testing this research’s conceptual model to investigate whether or not compulsive buying behavior (CBB) has a mediating impact in the link between materialism values and consumers’ life satisfaction. The researcher adopted a quantitative research design and used a single-stage cluster sampling technique and mono method for data gathering through distributing a large-scale questionnaire instrument. The structural equation modelling (SEM) methodology was implemented. The findings confirmed that the model is specified and yields a fit. Results uncovered that amid Covid-19 pandemic, materialism and individual’s life satisfaction are insignificantly associated except for the happiness sub-component of materialism. Furthermore, the association between materialistic values and CBB is insignificant except for the happiness sub-component. There is an insignificant effect of CBB on individual’s life satisfaction. To add, CBB doesn’t mediate the relationship between materialism and individual’s life satisfaction. This entails that Egyptian consumers consider having possessions a source for happiness but not the core of success. They are engaged in compulsive consumption for happiness and this may not lead to life satisfaction. This implies that Covid-19 may have produced pressures on Egyptian consumers to seek happiness through buying behaviors. Consequently, marketers should have several interventions to the feelings of happiness and consumers’ general life satisfaction in their messages and social marketing campaigns.

The European Road Safety Charter: Engaging citizens in improving road safety

The European Road Safety Charter (ERSC) is a large platform encouraging civil society to act on road safety. The ERSC objectives are: (1) encourage and support associations, schools, universities, companies and authorities to take action; (2) acknowledge contributions to road safety improvements by civil society; (3) facilitate civil society members in acquiring and sharing knowledge; and (4) facilitate dialogue for the transfer of experiences and practices at all levels in the EU. A community of over 3600 members has been created – companies, associations, research institutes, universities, NGOs, public authorities and schools. The ERSC members are supported by National Relays and a central coordination team. The most visible activity is the annual Excellence in Road Safety Awards, celebrating best practices from across Europe. Over the next years the network will be further expanded.

О традициях изучения правового плюрализма, его формах и значении (часть 1)

The relevance of this work is due to the possibility of coexistence of various systems (subsystems) of law in society. Some social sciences, such as anthropology, sociology, are characterized by increased attention to these situations, their mostly positive assessment. Within the framework of jurisprudence, the multiplicity of legal systems (subsystems) causes an ambiguous attitude, but has practical significance. At the same time, the existing approaches to the problem need to be systematized. Methodology. Dialectics, comparative method, formal-logical method, system approach, analysis, synthesis were used. Results. Various traditions of studying the multiplicity of systems (subsystems) of law are presented, studied and classified. Taking into account the generalization of scientific views, conclusions are drawn regarding possible forms of pluralism of law, its significance for society, its social groups, individuals, as well as prospects for increasing or decreasing pluralism of law. Conclusion. It is concluded that the pluralism of law does not reflect all social and legal diversity, and is not only a positive or negative phenomenon. Certain specific forms of pluralism of law should be assessed as contradictory, but quite natural (inevitable, necessary) for a certain historical moment of the situation. On the one hand, they may arise as a temporary phenomenon during the formation or disintegration of a large society. On the other hand, stable societies, especially complex, multi-component ones, are also inherent on a limited scale. Within the framework of the State, some forms of pluralism of law may have a positive meaning, while others may play a negative role. This phenomenon also has an ambiguous meaning for social groups belonging to societies and individuals.

The social role of song in wild zebra finches

Male songbirds sing to establish territories and to attract mates.1,2 However, increasing reports of singing in non-reproductive contexts3 and by females4,5 show that song use is more diverse than previously considered. Therefore, alternative functions of song, such as social cohesion3 and synchronization of breeding, by and large, were overlooked even in such well-studied species such as the zebra finch (Taeniopygia guttata). In these social songbirds, only the males sing, and pairs breed synchronously in loose colonies,6,7 following aseasonal rain events in their arid habitat.8,9 As males are not territorial, and pairs form long-term monogamous bonds early in life, conventional theory predicts that zebra finches should not sing much at all; however, they do and their song is the focus of hundreds of lab-based studies.10,11,12,13,14,15,16,17,18,19,20,21,22 We hypothesize that zebra finch song functions to maintain social cohesion and to synchronize breeding. Here, we test this idea using data from 5 years of field studies, including observational transects, focal and year-round audio recordings, and a large-scale playback experiment. We show that zebra finches frequently sing while in groups, that breeding status influences song output at the nest and at aggregations, that they sing year round, and that they predominantly sing when with their partner, suggesting that the song remains important after pair formation. Our playback reveals that song actively features in social aggregations as it attracts conspecifics. Together, these results demonstrate that birdsong has important functions beyond territoriality and mate choice, illustrating its importance in coordination and cohesion of social units within larger societies.

Co-expression Gene Networks and Machine-learning Algorithms Unveil a Core Genetic Toolkit for Reproductive Division of Labour in Rudimentary Insect Societies.

The evolution of eusociality requires that individuals forgo some or all their own reproduction to assist the reproduction of others in their group, such as a primary egg-laying queen. A major open question is how genes and genetic pathways sculpt the evolution of eusociality, especially in rudimentary forms of sociality-those with smaller cooperative nests when compared with species such as honeybees that possess large societies. We lack comprehensive comparative studies examining shared patterns and processes across multiple social lineages. Here we examine the mechanisms of molecular convergence across two lineages of bees and wasps exhibiting such rudimentary societies. These societies consist of few individuals and their life histories range from facultative to obligately social. Using six species across four independent origins of sociality, we conduct a comparative meta-analysis of publicly available transcriptomes. Standard methods detected little similarity in patterns of differential gene expression in brain transcriptomes among reproductive and non-reproductive individuals across species. By contrast, both supervised machine learning and consensus co-expression network approaches uncovered sets of genes with conserved expression patterns among reproductive and non-reproductive phenotypes across species. These sets overlap substantially, and may comprise a shared genetic "toolkit" for sociality across the distantly related taxa of bees and wasps and independently evolved lineages of sociality. We also found many lineage-specific genes and co-expression modules associated with social phenotypes and possible signatures of shared life-history traits. These results reveal how taxon-specific molecular mechanisms complement a core toolkit of molecular processes in sculpting traits related to the evolution of eusociality.

On the interplay of hierarchies, conflicts, and cooperation: An experimental approach.

Previous research suggests that it is difficult to maintain cooperation in a large society when there is a strong hierarchical structure. In this study, we implement online human experiments to study the effects of exogenous variation in a particular notion of hierarchy on cooperation and conflict within groups. We demonstrate how cooperation can be maintained when collective action is accompanied by dyadic conflicts whose outcome feeds back on the hierarchical rank of the contestants. We find that the majority of individuals take part in conflicts and that highly ranked individuals mostly cooperate and engage in conflicts as a way to punish noncooperators. As a consequence, stable hierarchical groups can arise and maintain high levels of cooperation. Our results are in agreement with the prediction of earlier theoretical models on hierarchical societies and are relevant to understanding the interplay of hierarchy, cooperation, and conflict.

Reply to Joachim Krueger's Review of Rationality

I enjoyed Joachim Krueger's thoughtful and good-natured review of Rationality. As fellow students of rationality and irrationality, including self-serving biases, neither of us will be surprised that I wish to defend myself in the face of some of his gentle critical remarks.Krueger suggests that I anchored my story in the mainstream heuristics-and-biases school of reasoning. But members of that school beg to differ: Some have given me a hard time for being too nice to their adversaries such as Gerd Gigerenzer, Ralph Hertwig, Daniel Kahan, and Leda Cosmides. While acknowledging the monumental contributions of Tversky, Kahneman, Slovic, and others, my own portrait of the human mind is more charitable to our species than the bag-of-biases and reflexive-caveman images that are often associated with that school. Starting from the first chapter, in which I tout the rationality of the San hunter–gatherers of the Kalahari (including their Bayesian reasoning), I present many defenses of human reasoning in ecologically natural circumstances, together with suggestions on how people's intuitions can be enhanced to grasp normative principles, a prospect about which the heuristics-and-biases theorists tend to be pessimistic.Overall, I agree with Krueger's approach to rationality more than his review suggests. I agree that trust, together with other social emotions such as sympathy, evolved as adaptations to solve prisoner's dilemmas, and I wrote as much on p. 242 (and in greater depth in How the Mind Works and The Better Angels of Our Nature). The problem, of course, is that the solutions don't scale well beyond close-knit social networks. In larger societies, and on the international scale, cheaters can exploit others’ trust, and the temptations for defection can be enormous. Here the famous Russian watchword applies: Trust but verify.I agree, too, that ignorance can be rational (see the section “Rational Ignorance,” pp. 56–58), that loss aversion is an adaptation to the singularity of death, and that individual rationality can subvert collective welfare. I disagree, though, with the suggestion that “methodological individualism” is a “sacred tenet of the Enlightenment.” Enlightenment thinkers were obsessed with the tension between self-interested rationality and collective welfare, as we see in analyses of the social contract by Hobbes, Locke, Rousseau, Hume, Smith, and the framers of the American Constitution. For apposite quotes, see the epigraph to the chapter on game theory from Hume and, bracketing the chapter, the quote in the penultimate sentence from Hobbes.I also appreciated Krueger's own epigraph, from one of my favorite Dylan songs, “Things have changed.”

Severe olanzapine-induced liver function test elevation.

Dear Editor:We read with great interest the case report1 on identifying olanzapine-induced liver injury in the setting of acute hepatitis C. We wanted to bring to the attention of the Mental Health Clinician readers our similar case report entitled “Olanzapine-induced elevated liver function tests in an older person with antidepressant-induced mania”, who similarly experienced significant liver function test (LFT) elevation thought to be related to olanzapine that was published in The Senior Care Pharmacist in September 2022.2Although an increase in LFTs is a known adverse effect of antipsychotics including olanzapine, this is an underappreciated adverse effect, especially as the LFT elevation can be severe. Furthermore, there is no standard of care for monitoring LFTs at baseline or how frequently during antipsychotic treatment LFTs should be monitored.Brelje et al1 cites that olanzapine-induced liver injury has been shown to occur anywhere from 12 days to 8 years after initiating olanzapine, which is similar to what we found in published reports.1,2 In the case that Brelje et al reported, LFT elevation occurred after 6 days of olanzapine therapy and ALT peaked at 1510 IU/L.1 This is similar to the case recently published in The Senior Care Pharmacist of a 67-year-old male where LFT elevation began on day 6 of olanzapine treatment and peaked on day 8 with an AST of 2024 IU/L and ALT of 1508 IU/L.2If drug-induced liver injury or adverse effects of antipsychotics are topics of interest to the reader, we encourage you to read the Brelje et al1 article in the Mental Health Clinician as well as the Reid et al2 article in The Senior Care Pharmacist. The latter article reviews potential mechanisms of olanzapine-induced LFT elevation such as via a toxic intermediary metabolite or in relation to nonalcoholic fatty liver disease.2 Reid et al2 also summarizes 9 additional cases of olanzapine-induced LFT elevation.Brelje et al1 cites “large psychiatric professional societies have refrained from recommending widespread asymptomatic testing”(p213) of hepatic enzymes. However, both articles highlight how significantly elevated LFTs can become within 1 week of starting olanzapine treatment. We encourage readers to incorporate baseline monitoring and consider rechecking within 1 to 2 weeks of initiation with continued monitoring of LFTs in patients treated with antipsychotics including olanzapine into their routine practice.