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    For most Americans, protecting free expression means countering threats from government. Private corporations are not usually seen as threatening free speech. But as private technology companies increasingly mediate access to information and services, the distinction between governmental and private censorship becomes less clear. Concepts of free speech and freedom of expression may need to be revised and enlarged to take account of new threats in the age of digital communications – and policies to protect freedom of expression may need to counter threats, often subtle, from the private sector as well as government.

    New Censorship Technologies and Practices

    Since the invention of writing, heavy handed governmental forms of censorship targeted ideas or words deemed dangerous by authorities, but at the risk of drawing more attention and public debate to the ideas or words targeted for suppression. Contemporary threats, barely recognizable as censorship, more often come from steering or soft censorship. Using new communications technologies, corporations – and government agencies operating indirectly through corporations – are able to intervene in expressions before they happen. Search engines, auto-predictive keyboards, machine learning algorithms and filters originally designed to keep children safe on the Web have become tools for modifying citizen behavior and altering communications. A few examples help to illustrate these worrisome practices:

    • A recent update from Apple to the iPhone keyboard made it difficult for users to enter the words abortion or suicide into their smartphones. Whatever the intentions, this can make it difficult for iPhone users to take perfectly legal or constructive actions such as searching for abortion clinics or finding information about suicide prevention.
    • The source code of a recent Android handset update made by Google contains a dictionary of over 165,000 words users would not get help to complete from the auto predict or spell-check functions built into their devices – including terms like preggers, intercourse, lovemaking, butt, geek, thud, pizzle, and other supposedly dirty words.
    • In mainland China, searches for “human rights” on Google often return the question “Did you mean hunan rice?” and a series of rice-based recipes.
    • Edward Snowden’s revelations about digital surveillance by the National Security Agency suggest that U.S. technology companies have been surprisingly amenable to surrendering user data to intelligence authorities, with companies like Microsoft providing government easier access to its services through Skype, Outlook email, and SkyDrive cloud storage.
    • Blocking or tracking taboo words or language is a particularly useful way for understanding next-generation censorship. Many of these soft censorship technologies interfere with people’s use of certain words or expressions – or enable surveillance actors to track ideas or communications defined as threatening or undesirable.

    Tracking and Steering Citizen-Users

    Digital communications technology has also proven to be useful for collecting information about users in order to predict their needs and desires and steer their behavior. Unlike media manipulation or propaganda, which focuses on changing popular beliefs and social behaviors on a large scale, digital approaches aim to track, predict, and manipulate the behavior of individual users. For instance, Facebook’s “News Feed” has long tried to shape users’ choices by algorithmically predicting which content is most likely to keep people on the site and automatically removing content that users might find uninteresting or objectionable. For this company and many others, there is little need to challenge or change user beliefs in overt ways when more subtle forms of steering are possible given the ease of collecting and analyzing digital data on what individuals are doing or what they might find attractive or unappealing.

    Protecting Free Expression in a New Era

    Given the subtlety of contemporary forms of censorship and steering often practiced by private corporations, freedom of expression and choice can no longer be construed simply in terms of protection against governmental infringements. By better understanding the newest mechanisms for regulating language and steering citizens, we become better able to make informed policy decisions. Several new ways to protect free expression should be considered for the digital age.

    • Independent auditors may need to review search engines and algorithms, given their enormous power to shape what can be found on the Internet and how findings are ranked. Private companies have a legitimate interest in protecting their private intellectual property, but it should be possible for auditors to certify that search engines are not biased or designed to be coercive without divulging any details that amount to true trade secrets.
    • Users should not be regarded as disinterested in the possible biases of steering devices. Terms of service agreements could be simplified and rewritten so as not to discourage users from peering into the operations of the services they use.
    • New public technology services may also be needed. Instead of a proprietary search algorithms like Google, open-source search engines could be created along the same lines as Wikipedia, with users contributing to the creation and operation of searches. Algorithmic gatekeepers could be opened up and made intelligible to people with little technical knowledge. Universities might be best equipped to administer public knowledge platforms, because they are present in many countries and regions, enjoy academic freedom in many parts of the world, and have access to advanced research resources and technical experts not dependent on corporations for employment.

    Well-designed new policies and institutions could help democratic nations – and peoples aspiring to freedom – to parry manipulative uses of digital technologies. Optimal policies must be future-oriented and able to accommodate rapidly changing technologies. Of course, new technologies and the companies that devise and deploy them deserve to prosper in coming decades – but only in ways that protect vital public interests in transparency and full freedom of expression.

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    Rex Troumbley is a Postdoctoral Fellow at Rice University. His research deals with how taboo language – cursing, swearing, profanity, obscenity, and racial slurs – is managed by medical, legal, and technical institutions in the United States. This article was written in collaboration with Scholar Strategy Network.

    Health

    Study Shows Immune Cells Against Covid-19 Stay High in Number Six Months After Vaccination

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    A recent study by Johns Hopkins Medicine researchers provides evidence that CD4+ T lymphocytes — immune system cells also known as helper T cells — produced by people who received either of the two available messenger RNA (mRNA) vaccines for COVID-19 persist six months after vaccination at only slightly reduced levels from two weeks after vaccination and are at significantly higher levels than for those who are unvaccinated.

    The researchers also found that the T cells they studied recognize and help protect against the delta variant of SARS-CoV-2, the virus that causes COVID-19. According to the U.S. Centers for Disease Control and Prevention, the delta variant — currently the predominant strain of SARS-CoV-2 in the United States — causes more infections and spreads faster than earlier forms of the virus.

    The study findings were first reported online Oct. 25, 2021, in the journal Clinical Infectious Diseases.

    “Previous research has suggested that humoral immune response — where the immune system circulates virus-neutralizing antibodies — can drop off at six months after vaccination, whereas our study indicates that cellular immunity — where the immune system directly attacks infected cells — remains strong,” says study senior author Joel Blankson, M.D., Ph.D., professor of medicine at the Johns Hopkins University School of Medicine. “The persistence of these vaccine-elicited T cells, along with the fact that they’re active against the delta variant, has important implications for guiding COVID vaccine development and determining the need for COVID boosters in the future.”

    To reach these findings, Blankson and his colleagues obtained blood from 15 study participants (10 men and five women) at three times: prior to vaccination, between seven and14 days after their second Pfizer/BioNTech or Moderna vaccine dose, and six months after vaccination. The median age of the participants was 41 and none had evidence of prior SARS-CoV-2 infection.

    CD4+ T lymphocytes get their nickname of helper T cells because they assist another type of immune system cell, the B lymphocyte (B cell), to respond to surface proteins — antigens — on viruses such as SARS-CoV-2. Activated by the CD4+ T cells, immature B cells become either plasma cells that produce antibodies to mark infected cells for disposal from the body or memory cells that “remember” the antigen’s biochemical structure for a faster response to future infections. Therefore, a CD4+ T cell response can serve as a measure of how well the immune system responds to a vaccine and yields humoral immunity.

    In their study, Blankson and colleagues found that the number of helper T cells recognizing SARS-CoV-2 spike proteins was extremely low prior to vaccination — with a median of 2.7 spot-forming units (SFUs, the level of which is a measure of T cell frequency) per million peripheral blood mononuclear cells (PBMCs, identified as any blood cell with a round nucleus, including lymphocytes). Between 7 and 14 days after vaccination, the T cell frequency rose to a median of 237 SFUs per million PBMCs. At six months after vaccination, the level dropped slightly to a median of 122 SFUs per million PBMCs — a T cell frequency still significantly higher than before vaccination.

    The researchers also looked six months after vaccination at the ability of CD4+ T cells to recognize spike proteins atop the SARS-CoV-2 delta variant. They discovered the number of T cells recognizing the delta variant spike protein was not significantly different from that of T cells attuned to the original virus strain’s protein.

    Although the study was limited because of the small number of participants, Blankson feels it pinpoints areas that merit further research.

    “The robust expansion of T cells in response to stimulation with spike proteins is certainly indicated, supporting the need for more study to show booster shots do successfully increase the frequency of SARS-CoV-2-specific T cells circulating in the blood,” says Blankson. “The added bonus is finding that this response also is likely strong for the delta variant.”

    Along with Blankson, the members of the study team from Johns Hopkins Medicine are study lead author Bezawit Woldemeskel and Caroline Garliss.

    This study was supported by the Johns Hopkins COVID-19 Vaccine-related Research Fund.

    The authors do not have financial or conflict of interest disclosures. 

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    Health

    Poverty, Racism and the Public Health Crisis in America

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    Although extreme poverty in the United States is low by global standards, the U.S. has the worst index of health and social problems as a function of income inequality. In a newly published article, Bettina Beech, clinical professor of population health in the Department of Health Systems and Population Health Sciences at the University of Houston College of Medicine and chief population health officer at UH, examines poverty and racism as factors influencing health.

    “A common narrative for the relatively high prevalence of poverty among marginalized minority communities is predicated on racist notions of racial inferiority and frequent denial of the structural forms of racism and classism that have contributed to public health crises in the United States and across the globe,” Beech reports in Frontiers in Public Health. “Racism contributes to and perpetuates the economic and financial inequality that diminishes prospects for population health improvement among marginalized racial and ethnic groups. The U.S. has one of the highest rates of poverty in the developed world, but despite its collective wealth, the burden falls disproportionately on communities of color.” The goal of population health is to achieve health equity, so that every person can reach their full potential.

    Though overall wealth has risen in recent years, growth in economic and financial resources has not been equally distributed. Black families in the U.S. have about one-twentieth the wealth of their white peers on average. For every dollar of wealth in white families, the corresponding wealth in Black households is five cents.

    “Wealth inequality is not a function of work ethic or work hour difference between groups. Rather, the widening gap between the affluent and the poor can be linked to unjust policies and practices that favor the wealthy,” said Beech. “The impact of this form of inequality on health has come into sharp focus during the COVID-19 pandemic as the economically disadvantaged were more likely to get infected with SARS CoV-2 and die.”

    A Very Old Problem 

    In the mid-1800’s, Dr. James McCune Smith wrote one of the earliest descriptions of racism as the cause of health inequities and ultimately health disparities in America. He explained the health of a person “was not primarily a consequence of their innate constitution, but instead reflected their intrinsic membership in groups created by a race structured society.”

    Over 100 years later, the Heckler Report, the first government-sanctioned assessment of racial health disparities, was published. It noted mortality inequity was linked to six leading causes of preventable excess deaths for the Black compared to the white population (cancer, cardiovascular disease, diabetes, infant mortality, chemical dependency and homicide/unintentional injury).

    It and other reports led to a more robust focus on population health over the last few decades that has included a renewed interest in the impact of racism and social factors, such as poverty, on clinical outcomes.

    The Myth of Meritocracy

    Beech contends that structural racism harms marginalized populations at the expense of affording greater resources, opportunities and other privileges to the dominant white society.

    “Public discourse has been largely shaped by a narrative of meritocracy which is laced with ideals of opportunity without any consideration of the realities of racism and race-based inequities in structures and systems that have locked individuals, families and communities into poverty-stricken lives for generations,” she said. “Coupled with a lack of a national health program this condemns oppressed populations such as Black and Hispanic Americans, American Indians, and disproportionately non-English speaking immigrants and refugees to remain in poverty and suffer from suboptimal health.”

    Keys to Improvement

    The World Health Organization identified three keys to improving health at a global level that each reinforces the impact of socioeconomic factors: (1) improve the conditions of daily life; (2) tackle the inequitable distribution of power, money and resources; and (3) develop a workforce trained in and public awareness of the social determinants of health.

    The report’s findings highlight the need to implement health policies to increase access to care for lower-income individuals and highlight the need to ensure such policies and associated programs are reaching those in need.

    “Health care providers can directly address many of the factors crucial for closing the health disparities gap by recognizing and trying to mitigate the race-based implicit biases many physicians carry, as well as leveraging their privilege to address the elements of institutionalized racism entrenched within the fabric of our society, starting with social injustice and human indifference,” said Beech.

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    Mental Health

    When Giving Thanks, Don’t Forget Yourself

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    As we give thanks at the holidays, it’s easy to overlook someone important: your past self.

    While it’s well documented that gratitude toward others can improve wellbeing, two University of Florida scientists find that gratitude toward your past self also has benefits.

    Does thanking yourself seem a bit…selfish? The researchers, UF psychology professor Matt Baldwin, Ph.D., and undergraduate student Samantha Zaw, think not.

    “Despite the fact that past gratitude is self-focused, it reminds people that they’re part of a bigger story and that they have the power to grow,” Baldwin said. “It’s possible this promotes a pay-it-forward type of mentality.”

    Gratitude is what psychologists call a self-transcendent emotion, one that lifts us out of the everyday and expands our perspective, which can help us get along with each other better. In a recent experiment, Baldwin and Zaw asked participants to write brief gratitude letters. The first group thanked someone else, the second thanked themselves, while a third, the control condition, wrote about a positive experience they’d had. Zaw and Baldwin then surveyed the participants about their self-perception after writing the letter. Although the results are not yet published, early analysis shows that the exercise gave the other- and self-focused gratitude groups a sense of redemption and helped them feel they were morally good people. However, the group that wrote to themselves scored higher on both measures.

    The past-self group also saw a benefit the others didn’t: an increase in the self-awareness measures of clarity, authenticity and connectedness.

    “Unlike gratitude toward others, being appreciative of ourselves carries an added benefit of truly understanding who we are and feeling connected to ourselves,” said Zaw, a McNair Scholar who has been working with Baldwin since her freshman year as part of UF’s Emerging Scholars Program.

    Zaw and Baldwin’s research — the first known data gathered on past-self gratitude — was inspired by a Reese’s cup. When Baldwin’s co-worker, boredom researcher Erin Westgate, returned to the office after pandemic lockdown, she was delighted to discover a peanut butter cup she had squirreled away in her desk.

    “She texted me like, ‘Oh my gosh, my past self left my future self a Reese’s,’” Baldwin recalled. “I was like, ‘Wait a second. You’re expressing gratitude towards something your past self had done. We have to study this.’”

    As Zaw and Baldwin dug into previous studies, they found plenty on gratitude toward others and a few on self-compassion, but nothing on past-self gratitude. They designed the letter-writing experiment to test its effects, presenting their findings at the Society of Southeastern Social Psychologists in October and at the upcoming meeting of the Society for Personality and Social Psychology in February.

    If you’re curious about the benefits of self-gratitude, Zaw offered a way to try the experiment at home, maybe as a new Thanksgiving tradition. Take a few minutes to write a thank you message to someone else, and another to yourself for something you did in the past. Sharing what you wrote could foster connections between loved ones, she said, but the exercise can also pay dividends if you try it on your own.

    “At Thanksgiving and Christmas, we focus on other people, but self-care is really needed too, especially if we want to feel more clear about ourselves,” she said. “Maybe it can even lead to a better vision for ourselves for the next year.”

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