Patient Advocacy, Drug Promotion, and the Feminist Paradox: An Analysis of the Canadian Pain Coalition

Healthcare has changed significantly over the past few decades with the emergence of neoliberalism as a dominant ideology informing policy. This paper examines the Canadian Pain Coalition’s (CPC) conceptualization of chronic pain and its treatment in the context of neoliberalism. Through content analysis of the CPC’s online materials, we show how the advocacy group constructs pain as an individual’s responsibility and a physical disease that can be managed primarily with pharmaceutical medication.  Drawing on insights from the social determinants of health and feminist literatures, we suggest that the CPC’s construction of pain as a physical disease, an individual responsibility, and its emphasis on pharmaceutical treatment is inadequate in addressing the complex social, economic, and physical needs of people living with chronic pain.  Taking up Susan Markens’ concept of the “feminist paradox,” we suggest that there is a necessary tension in the construction of pain as disease.  On the one hand, it is constructed in terms of providing access to treatments, while on the other, it potentially medicalizes people living with chronic pain.  Finally, we discuss how the CPC does not adequately address the side of the tension concerning medicalization, given the strong association between the CPC and the pharmaceutical companies

Using a realist approach to evaluate smoking cessation interventions targeting pregnant women and young people

Background This paper describes a study protocol designed to evaluate a programme of smoking cessation interventions targeting pregnant women and young people living in urban and rural locations in Northeast Scotland. The study design was developed on so-called 'realist' evaluation principles, which are concerned with the implementation of interventions as well as their outcomes. Methods/design A two-phased study was designed based on the Theory of Change (TOC) using mixed methods to assess both process and outcome factors. The study was designed with input from the relevant stakeholders. The mixed-methods approach consists of semi-structured interviews with planners, service providers, service users and non-users. These qualitative interviews will be analysed using a thematic framework approach. The quantitative element of the study will include the analysis of routinely collected data and specific project monitoring data, such as data on service engagement, service use, quit rates and changes in smoking status. Discussion The process of involving key stakeholders was conducted using logic modelling and TOC tools. Engaging stakeholders, including those responsible for funding, developing and delivering, and those intended to benefit from interventions aimed at them, in their evaluation design, are considered by many to increase the validity and rigour of the subsequent evidence generated. This study is intended to determine not only the components and processes, but also the possible effectiveness of this set of health interventions, and contribute to the evidence base about smoking cessation interventions aimed at priority groups in Scotland. It is also anticipated that this study will contribute to the ongoing debate about the role and challenges of 'realist' evaluation approaches in general, and the utility of logic modelling and TOC approaches in particular, for evaluation of complex health interventions

Discovery of charge density wave in a correlated kagome lattice antiferromagnet

A hallmark of strongly correlated quantum materials is the rich phase diagram resulting from competing and intertwined phases with nearly degenerate ground state energies. A well-known example is the copper oxides, where a charge density wave (CDW) is ordered well above and strongly coupled to the magnetic order to form spin-charge separated stripes that compete with superconductivity. Recently, such rich phase diagrams have also been revealed in correlated topological materials. In two-dimensional kagome lattice metals consisting of corner-sharing triangles, the geometry of the lattice can produce flat bands with localized electrons, non-trivial topology, chiral magnetic order, superconductivity and CDW order. While CDW has been found in weakly electron correlated nonmagnetic AV3Sb5 (A = K, Rb, Cs), it has not yet been observed in correlated magnetic ordered kagome lattice metals. Here we report the discovery of CDW within the antiferromagnetic (AFM) ordered phase of kagome lattice FeGe. The CDW in FeGe occurs at wavevectors identical to that of AV3Sb5, enhances the AFM ordered moment, and induces an emergent anomalous Hall effect. Our findings suggest that CDW in FeGe arises from the combination of electron correlations-driven AFM order and van Hove singularities-driven instability possibly associated with a chiral flux phase, in stark contrast to strongly correlated copper oxides and nickelates, where the CDW precedes or accompanies the magnetic order.Comment: 36 pages, 4 figures in main tex

Effects of vitamin D on inflammatory and oxidative stress responses of human bronchial epithelial cells exposed to particulate matter

PEP was a Wellcome Trust Clinical Research Training Fellow and this research was supported by the Wellcome Trust (Grant 098882/Z/12/Z). This research was also supported by the National Institute for Health Research (NIHR) Clinical Research Facility at Guy’s & St Thomas’ NHS Foundation Trust and NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London

Can We Really Prevent Suicide?

Every year, suicide is among the top 20 leading causes of death globally for all ages. Unfortunately, suicide is difficult to prevent, in large part because the prevalence of risk factors is high among the general population. In this review, clinical and psychological risk factors are examined and methods for suicide prevention are discussed. Prevention strategies found to be effective in suicide prevention include means restriction, responsible media coverage, and general public education, as well identification methods such as screening, gatekeeper training, and primary care physician education. Although the treatment for preventing suicide is difficult, follow-up that includes pharmacotherapy, psychotherapy, or both may be useful. However, prevention methods cannot be restricted to the individual. Community, social, and policy interventions will also be essentia

Are mental health and binge drinking associated in Dutch adolescents? Cross-sectional public health study

<p>Abstract</p> <p>Background</p> <p>Depression and anxiety disorders have a high disease burden and as many as 15% of young people report mental health problems. Binge drinking, which is a particularly harmful way of consuming alcohol, is common among secondary school students. The aim of this study was to examine the association between binge drinking and self-reported mental health in boys and girls aged 12 to 18 years.</p> <p>Findings</p> <p>This cross-sectional analysis was performed on data collected by the Community Health Service (GGD) Brabant Zuidoost, the Netherlands, in 2007. In this Youth Survey, 10 090 randomly selected adolescents aged 12 tot 18 years were each sent a letter, a questionnaire, and a user name and log-in code for if they preferred to complete the Internet version of the questionnaire. Mental health was assessed using the Mental Health Inventory (MHI-5), a short 5-item questionnaire to detect feelings of depression and anxiety. Participants were asked about current alcohol consumption, their relationship with their parents, drug use, and sociodemographic data.</p> <p>Corrected for confounders, binge drinking and mental health problems were associated in the 12 to 15 year old girls (OR 2.43; 95% CI 1.86-3.17, p = 0.000) and boys (OR 1.64, 95% CI 1.19-2.27, p = 0.003). The majority of the 16 to 18 year old adolescents had been binge drinking in the previous 4 weeks (69.6% boys and 56.8% girls). In this age group, boys with mental health problems were less likely to be classified as binge drinkers than were boys without mental health problems (OR 0.63, 95% CI 0.45-0.87, p = 0.005). No such association between binge drinking and mental health was found in girls of this age.</p> <p>Conclusion</p> <p>Girls and boys aged 12-15 years were classified as binge drinkers significantly more often when they reported poor mental health. Because binge drinking damages the brain, especially at a young age, it is important that health professionals are alert to possible binge drinking when young adolescents report mental health problems and should ask their patients about their drinking behaviour. Likewise, if youngsters under 16 present with binge drinking, they should be asked whether they are anxious or depressed.</p

Visualising the visceral: using film to research the ineffable

While cheaper technology, wider training availability and the online digital learning environment have broadened the opportunities for geographers to use film and video, it has also led to calls to improve the discipline’s media literacy. This need is made even more urgent by the shift in qualitative research to practice-based methods targeted towards how we experience our lived environment. Other shifts in empirical and conceptual focus are also relevant, particularly interest in emotional beneath the surface geographies and calls for participation rather than observation encased in recent debates on the Anthropocene. The negative association of film with entertainment and marketeering has led to concerns about the suitability of film as a research output and has led some scholars to restrict themselves to a stringent use of real-time ‘video’ in a primarily data-collection context. This paper adopts a practice-based approach in order to identify some of the complex qualities that a research film holds and contribute to the debate about its future as a form of academic research and publication. Reflecting on a recent film-based research project on heritage tourism in Syria and Jordan I argue that the potential to manipulate, distort or entertain should not be ignored or refuted. Rather the wide range of relationships between people, objects and landscape within the frame such as depth of field, mise-en-scene and between the frames via editing (montage) give film a complex viscerality and multi-sensorial power that can help us explore how we communicate our feelings and connect the experiential qualities of filmic research methods to final outputs.This work was supported by the Economic and Social Research Council grant number RES-062-23-324