Invited to labour or participate: intra- and inter-generational distinctions and the role of capital in children’s invited participation

This paper applies aspects of Bourdieu’s conceptual toolkit related to capital, and analyses inter- and intra-generational relations of influence. Applying Bourdieu’s concepts to examples of case studies from a children’s parliament in Finland, and with reference to an adult resident forum, moments of continuity and disruption in the relatively stable patterns of distinction between children and adults emerge. Children in school councils (at times) are labourers for agendas set by teachers, but the children at the top of the structure’s hierarchy can benefit from cultural capital and a functional capital that enables them to set agendas and direct the work of others. The political capital of the person presenting views from the participation sphere and the dominant symbolic capital of market logics appear to have a greater impact than generation on the influence participants achieve. Unquestioned acceptance of this differentiation suggests that new approaches to invited participation structures are needed

Postoperative pain management with transdermal fentanyl after forefoot surgery: a randomized, placebo-controlled study

Riika Merivirta,1 Mikko Pitkänen,2 Jouko Alanen,3 Elina Haapoja,1 Mari Koivisto,4 Kristiina Kuusniemi11Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine of Turku University Hospital and University of Turku, Turku, 2Department of Anaesthesia, Hospital Orton, Invalid Foundation, Helsinki, 3Terveystalo Clinic Hospital, Helsinki, 4Department of Biostatistics, University of Turku, Turku, FinlandBackground: Quality of life is decreased in patients with hallux valgus deformity, mainly because of pain. Significant improvement is usually achieved by surgery. However, postoperative pain can be moderate to severe for 2–3 days. The aim of the present study was to evaluate the use of transdermal fentanyl for postoperative pain management after forefoot surgery.Methods: Sixty patients undergoing hallux valgus or hallux rigidus surgery were allocated to receive a patch delivering either fentanyl 12 µg/hour or placebo for postoperative pain. The consumption of rescue opioid oxycodone, the primary outcome measure, was evaluated daily until the fourth postoperative day. Total consumption of oxycodone during the study period was also assessed. Pain scores and possible adverse effects were evaluated every 6 hours during the first 24 hours and on the fourth postoperative day.Results: The use of rescue opioid was low in both groups, the median (range) consumption of oxycodone being 10 (0–50) mg on the day of surgery (no difference between the groups, P=0.31) and 0 (0–35) mg thereafter. The total combined consumption was 10 (0–105) mg in the fentanyl group and 20 (0–70) mg in the placebo group (P=0.23). There were no statistically significant differences in pain scores or adverse effects between the groups.Conclusion: As a part of multimodal analgesia with ibuprofen and acetaminophen, a patch delivering fentanyl 12 µg/hour did not significantly decrease the consumption of rescue opioid or pain scores after forefoot surgery.Keywords: pain management, transdermal fentanyl, multimodal analgesia, forefoot surgery, hallux valgus, hallux rigidu