"I feel so stupid because I can't give a proper answer ..." How older adults describe chronic pain: a qualitative study

Background - Over 50% of older adults experience chronic pain. Poorly managed pain threatens independent functioning, limits social activities and detrimentally affects emotional wellbeing. Yet, chronic pain is not fully understood from older adults’ perspectives; subsequently, pain management in later life is not necessarily based on their priorities or needs. This paper reports a qualitative exploration of older adults’ accounts of living with chronic pain, focusing on how they describe pain, with a view to informing approaches to its assessment. Methods - Cognitively intact men and women aged over sixty-five who lived in the community opted into the study through responding to advertisements in the media and via contacts with groups and organisations in North-East Scotland. Interviews were transcribed and thematically analysed using a framework approach. Results - Qualitative individual interviews and one group interview were undertaken with 23 older adults. Following analysis, the following main themes emerged: diversity in conceptualising pain using a simple numerical score; personalising the meaning of pain by way of stories, similes and metaphors; and, contextualising pain in relation to its impact on activities. Conclusions - The importance of attending to individuals’ stories as a meaningful way of describing pain for older adults is highlighted, suggesting that a narrative approach, as recommended and researched in other areas of medicine, may usefully be applied in pain assessment for older adults. Along with the judicious use of numerical tools, this requires innovative methods to elicit verbal accounts, such as using similes and metaphors to help older adults describe and discuss their experience, and contextualising the effects of pain on activities that are important to them

In a Trinitarian Embrace: Reflections from a Local Eucharistic Community in a Global World

The context of the chapter is an Anglican “liberal Catholic” congregation in the Church of England, within a multicultural northern UK city, where those who gather represent the diversity of the globalized, postcolonial world. The chapter highlights the relationship between Anglo-Catholic Eucharistic liturgy, with its Trinitarian form, and feminist commitment to justice-making. The exclusion of feminist reimagining from current rethinking of Trinitarian theology is challenged by affirming the place of a sparse Trinitarian rule, in order to expose heteropatriarchal contraventions of the rule and then to re-site feminist reimagining in relation to it. This enables female imagery for God to infuse, rather than displace, classical liturgical language of God as Father-Son-Spirit, and undermines deeply entrenched heteropatriarchal contraventions. The metaphor of a Trinitarian embrace reflects this opening of the received Trinitarian liturgical form. The impetus for the feminist struggle for justice is found in being swept up into Christ through the Trinitarian missio Dei, in anticipation of the abundant table spread by Divine Wisdom for all people

Theology and cosmology beyond the Big Bang theory

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Economic growth, welfare models and inequality in the context of globalisation

The recent economic crisis was a test case for many advanced countries to determine the capacity of their socio-economic model to cope with the challenges of globalisation and financial crash. From this perspective, the aim of this article is to explore whether the expansion of the welfare state should be seen as a barrier to economic growth and competitiveness, as ‘neoliberal’ economists often argue, or whether increasing public social provision might contribute to enhancing real income. After a comparative discussion of the evolution of different welfare models in developed countries, we advance our argument that public social spending is not a drain on competitiveness or an obstacle to economic efficiency. On the contrary, we explore the possibility that increasing welfare expenditure can stimulate economic growth along with lowering inequality, while the so-called ‘efficiency thesis’ (according to which globalisation needs to be accompanied by the retrenchment of welfare states in order to promote external competitiveness) produces worse economic performance and higher inequality. As a test of this hypothesis, we analyse empirical data on 34 Organisation for Economic Co-operation and Development countries from 1990 to 2013. We use econometric analysis to indicate that the so-called ‘compensation thesis’ (a process whereby globalisation is regulated through expansion of welfare states) may contribute to real income dynamics, while greater income inequality may inhibit per capita gross domestic product growth