Social Death

This review will outline various ways in which the notion of 'social death’ can be understood, and how they can be related to clinical practice. The idea of social death is used to analytically represent how someone can be identified and treated as if they are ontologically deficient – meaning that they are not seen as being 'fully human.' This impacts on their position within society and how they are interacted with. This review will consider three examples of social death - often distinguished from physical or biological death - that are important for clinical practice: loss of agency and identity; treating people as if they are already dead; and, rituals and bereavement. Recognising that a distinction between social and biological death may not always be helpful, this review will suggest ways in which healthcare practitioners can minimise the likelihood of inadvertently treating someone as 'socially dead'

Multidisciplinary team meetings in palliative care: an ethnographic study

OBJECTIVES: Multidisciplinary team meetings are a regular feature in the provision of palliative care, involving a range of professionals. Yet, their purpose and best format are not necessarily well understood or documented. This article describes how hospital and community-based palliative care multidisciplinary team meetings operate to elucidate some of their main values and offer an opportunity to share examples of good practice. METHODS: Ethnographic observations of over 70 multidisciplinary team meetings between May 2018 and January 2020 in hospital and community palliative care settings in intercity London. These observations were part of a larger study examining palliative care processes. Fieldnotes were thematically analysed. RESULTS: This article analyses how the meetings operated in terms of their setup, participants and general order of business. Meetings provided a space where patients, families and professionals could be cared for through regular discussions of service provision. CONCLUSIONS: Meetings served a variety of functions. Alongside discussing the more technical, clinical and practical aspects that are formally recognised aspects of the meetings, an additional core value was enabling affectual aspects of dealing with people who are dying to be acknowledged and processed collectively. Insight into how the meetings are structured and operate offer input for future practice

A study of tilt change recorded from July to October 2006 at the Phlegraean Fields (Naples, Italy)

The tiltmetric dataset of Phlegraean Fields area showed a discrete correlation with the volcanic dynamics, suggesting that tiltmetric monitoring is important for the surveillance of active volcanic areas. Tilt data recorded in 2006 at 2 stations belonging to the monitoring network of the Osservatorio Vesuviano (INGV, National Institute for Geophysics and Volcanology, Italy) in the Phlegraean Fields are discussed in this paper. The acquired signals have shown a strong tiltmetric inversion that took place from the end of July 2006. After correcting tilt variations to eliminate the influence of temperature (influencing 90% of the signal at OLB station, hereafter OLB) a significant value of the tilt still remains. This change is related to a local inflation episode lasting 3 months, during an unrest phase that started 2 years before. It is interesting to note that tilt amplitude is much greater at OLB than the slope of the displacement field predicted by the theoretical inflation models, but data show that this field is not homogeneous and in some areas very tilted. Moreover, in the last days before the end of tilt inversion, a low energy seismic swarm happened at about 1 km of distance from the tiltmetric station by hundreds of VT (Volcano-Tectonics) and LP (Long-Period) events

Time-resolved x-ray spectroscopy of optical-field-ionized plasmas

The time-dependent soft X-ray emission of helium and nitrogen plasmas generated by optical-field ionization is reported. The experiments were carried out by focusing pulses of the high-power Ti:sapphire laser of the Lund Institute of Technology (lambda = 796 nm, pulse duration 150 fs, pulse energy 150 mJ) to a 50-mu m diameter spot close to a nozzle, using He and N-2 as target gases. The emission on He+, N4+, and N3+ resonance lines was recorded by means of a flat-field grating spectrometer coupled to an X-ray streak camera. A pronounced difference in the temporal shape of the emission of the Lyman-alpha line of hydrogen-like helium and of the 2p-3d resonance lines of lithium-like and beryllium-like nitrogen was observed. The helium line exhibited an initial spike followed by a slow revival of the emission, whereas the nitrogen lines showed a slow decay after a fast initial rise. These observations are explained with the help of simulations

‘It’s like being in a war with an invisible enemy’: A document analysis of bereavement due to COVID-19 in UK newspapers

The COVID-19 pandemic has been followed intensely by the global news media, with deaths and bereavement a major focus. The media reflect and reinforce cultural conventions and sense-making, offering a lens which shapes personal experiences and attitudes. How COVID-19 bereavement is reported therefore has important societal implications. We aimed to explore the reportage and portrayal of COVID-19 related bereavement in the top seven most-read British online newspapers during two week-long periods in March and April 2020. We conducted a qualitative document analysis of all articles that described grief or bereavement after a death from COVID-19. Analysis of 55 articles was informed by critical discourse analysis and Terror Management Theory, which describes a psychological conflict arising between the realisation that death is inevitable and largely unpredictable and the human need for self-preservation. We identified three main narratives: (1) fear of an uncontrollable, unknown new virus and its uncertain consequences—associated with sensationalist language and a sense of helplessness and confusion; (2) managing uncertainty and fear via prediction of the future and calls for behaviour change, associated with use of war metaphors; and (3) mourning and loss narratives that paid respect to the deceased and gave voice to grief, associated with euphemistic or glorifying language (‘passed away’, ‘heroes’). Accounts of death and grief were largely homogenous, with bereavement due to COVID-19 presented as a series of tragedies, and there was limited practical advice about what to do if a loved one became seriously ill or died. Reporting reflected the tension between focusing on existential threat and the need to retreat from or attempt to control that threat. While the impact of this reporting on the public is unknown, a more nuanced approach is recommended to better support those bereaved by COVID-19

SCOPE: a scorecard for osteoporosis in Europe

Summary The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Introduction The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis. Methods The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union (EU27). The information researched covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap). Results There was a marked difference in fracture risk among the EU27. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27, only a minority of patients at high risk receive treatment for osteoporosis even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Conclusions The scorecard will enable healthcare professionals and policy makers to assess their country’s general approach to the disease and provide indicators to inform future provision of healthcare

PMS61 Health-Related Quality of Life After Vertebral Fracture: Differences Between the EQ-5D and Time-Trade-Off Instruments

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Recent deformation at Campi Flegrei caldera (Italy) detected by DinSar and leveling techniques

The Campi Flegrei caldera, a volcanic and densely populated area located to the west of Napoli (Italy), was characterized by rapid ground deformation during 1970-72 and 1982-84, for a total amount of 3.5 m in the city of Pozzuoli. Since 1985 a slow deflation was active, with episodic microcrises of uplifts. A new and consistent uplift event is now going on, beginning in November 2004, as revealed by spatial and terrestrial geodetic techniques. In particular, we adopt almost all the available ENVISAT ASAR data acquired from both ascending and descending orbits during 2002-2006, to generate mean deformation velocity maps and time series with spatial resolution of about 100 m. The maps are computed following the Small BAseline Subset (SBAS) approach (Berardino et al., 2002), that implements an appropriate combination of differential interferograms generated from SAR data pairs (60 SAR images for this work). In addition to satellite observations, we show data from the high precision levelling network of the INGV-Osservatorio Vesuviano, consisting in about 320 benchmarks. Levelling measurements are regularly carried out on both the whole network and along the coast line; in case of a bradyseismic crisis, the temporal sampling is strongly increased. Both DInSAR and levelling data evidence the maximum value of the vertical displacement near the city of Pozzuoli. We model the observed deformation by means of 3D pressurized point-source and extended source, performing inversions to constrain their shape and location. The resulting sources are also compared with that inverted for the 1982-84 unrest.UnpublishedWienope