Evidence-based activism: Patients' organisations, users' and activist's groups in knowledge

This article proposes the notion of ‘evidence-based activism’ to capture patients’ and health activists’ groups’ focus on knowledge production and knowledge mobilisation in the governance of health issues. It introduces empirical data and analysis on groups active in four countries (France, Ireland, Portugal and the United Kingdom), and in four condition-areas (rare diseases, Alzheimer’s disease, ADHD – Attention Deficit Hyperactivity Disorder and childbirth). It shows how these groups engage with, and articulate a variety of credentialed knowledge and ‘experiential knowledge’ with a view to explore concerned people’s situations, to make themselves part and parcel of the networks of expertise on their conditions in their national contexts, and to elaborate evidence on the issues they deem important to address both at an individual and at a collective level. This article argues that in contrast to health movements which contest institutions from the outside, patients’ and activists’ groups which embrace ‘evidence-based activism’ work ‘from within’ to imagine new epistemic and political appraisal of their causes and conditions. ‘Evidence-based activism’ entails a collective inquiry associating patients/activists and specialists/professionals in the conjoint fabrics of scientific statements and political claims. From a conceptual standpoint, ‘evidence-based activism’ sheds light on the ongoing co-production of matters of fact and matters of concern in contemporary technological democracies

Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups

BACKGROUND: Conventional systematic review techniques have limitations when the aim of a review is to construct a critical analysis of a complex body of literature. This article offers a reflexive account of an attempt to conduct an interpretive review of the literature on access to healthcare by vulnerable groups in the UK METHODS: This project involved the development and use of the method of Critical Interpretive Synthesis (CIS). This approach is sensitised to the processes of conventional systematic review methodology and draws on recent advances in methods for interpretive synthesis. RESULTS: Many analyses of equity of access have rested on measures of utilisation of health services, but these are problematic both methodologically and conceptually. A more useful means of understanding access is offered by the synthetic construct of candidacy. Candidacy describes how people's eligibility for healthcare is determined between themselves and health services. It is a continually negotiated property of individuals, subject to multiple influences arising both from people and their social contexts and from macro-level influences on allocation of resources and configuration of services. Health services are continually constituting and seeking to define the appropriate objects of medical attention and intervention, while at the same time people are engaged in constituting and defining what they understand to be the appropriate objects of medical attention and intervention. Access represents a dynamic interplay between these simultaneous, iterative and mutually reinforcing processes. By attending to how vulnerabilities arise in relation to candidacy, the phenomenon of access can be better understood, and more appropriate recommendations made for policy, practice and future research. DISCUSSION: By innovating with existing methods for interpretive synthesis, it was possible to produce not only new methods for conducting what we have termed critical interpretive synthesis, but also a new theoretical conceptualisation of access to healthcare. This theoretical account of access is distinct from models already extant in the literature, and is the result of combining diverse constructs and evidence into a coherent whole. Both the method and the model should be evaluated in other contexts

NOXA-Induced Alterations in the Bax/Smac Axis Enhance Sensitivity of Ovarian Cancer Cells to Cisplatin

Ovarian cancer is the most common cause of death from gynecologic malignancy. Deregulation of p53 and/or p73-associated apoptotic pathways contribute to the platinum-based resistance in ovarian cancer. NOXA, a pro-apoptotic BH3-only protein, is identified as a transcription target of p53 and/or p73. In this study, we found that genetic variants of Bcl-2 proteins exist among cisplatin-sensitive and -resistant ovarian cancer cells, and the responses of NOXA and Bax to cisplatin are regulated mainly by p53. We further evaluated the effect of NOXA on cisplatin. NOXA induced apoptosis and sensitized A2780s and SKOV3 cells to cisplatin in vitro and in vivo. The effects were mediated by elevated Bax expression, enhanced caspase activation, release of Cyt C and Smac into the cytosol. Furthermore, gene silencing of Bax or Smac significantly attenuated NOXA and/or cisplatin-induced apoptosis in chemosensitive A2780s cells, whereas overexpression of Bax or addition of Smac-N7 peptide significantly increased NOXA and/or cisplatin-induced apoptosis in chemoresistant SKOV3 cells. To our knowledge, these data suggest a new mechanism by which NOXA chemosensitized ovarian cancer cells to cisplatin by inducing alterations in the Bax/Smac axis. Taken together, our findings show that NOXA is potentially useful as a chemosensitizer in ovarian cancer therapy

Critically evaluating collaborative research: why is it difficult to extend truth tests to reality tests?

We argue that critical evaluation achieves the reflexivity needed to facilitate collaboration by proposing boundary-negotiating artefacts to configure a joint action domain. Those objects become mediators for innovation by triggering controversies, conceived preventatively via an organized extension of what Boltanski calls ‘truth tests’ to ‘reality tests’ so that they dynamize ongoing affairs. However, critical evaluation must also anticipate actors’ reappropriation of boundary-negotiating artefacts in the effort to protect their rights, stakes or room for manoeuvre. Three scenarios commonly arise: avoidance or utopian projecting, enactment of inverted reality tests, and disavowal through role exchange. The article develops these propositions through the reconstruction of a modified theory-based evaluation of a collaborative research programme. The programme set out to explore how evidence from health research could be used rapidly and effectively in the context of practical problems and organizational challenges, so an internal evaluation was set up to facilitate learning during the process. What ensued, however, was a loss of trust between partners, resolved only by repositioning the evaluation as a reflective academic study, reducing its reflexive capacity to intervene on the level of activity and organizational integration. We conclude that doing successful critical evaluation and, more generally, achieving political pertinence for social scientific discourses depends on creating the conditions in which actors are able to take the risks and share the costs associated with the enhanced level of reflexivity necessary to engage in collective action as well as knowledge production

Validar a guerra: a construção do regime de Expertise estratégica

This article is intended to contribute to the interpretative analysis of war. For that purpose, it investigates how some apparatuses located in strategic thinking help to make modern war a social practice considered both technically feasible and, at the same time, legitimate for soldiers. In so doing, it makes use of two different but closely related theoretical fields, pragmatic sociology (finding inspiration in the work of scholars such as Luc Boltanski, Nicolas Dodier and Francis Chateauraynaud), and the sociology of scientific knowledge (based mostly on the work of Bruno Latour). On the one hand, the sociology of scientific knowledge has developed a productive questioning of the construction of scientific facts that is particularly relevant to the present research. On the other hand, pragmatic sociology generates a compatible framework able to describe collective actions. The combination of both approaches allows the description of the formation of a strategic expertise regime that supports the technical legitimacy of the use of military force. Together, the sociology of scientific knowledge and pragmatic sociology bring a particularly relevant perspective to research pertaining to war.info:eu-repo/semantics/publishe

A Reply to My Critics: The Critical Spirit of Bourdieusian Language

Drawing on my article “Bourdieusian reflections on language: Unavoidable conditions of the real speech situation”, this paper provides a detailed response to the above commentaries by Lisa Adkins, Bridget Fowler, Michael Grenfell, David Inglis, Hans-Herbert Kögler, Steph Lawler, William Outhwaite, Derek Robbins and Bryan S. Turner. The main purpose of this “Reply to my critics” is to reflect upon the most important issues raised by these commentators and thereby contribute to a more nuanced understanding of key questions arising from Bourdieu’s analysis of language