18 research outputs found
cartography of psychoactive heterotopias: A look at the medical, legal and social discourses regarding drug use
Este artículo traza un mapa del control social de las drogas a partir de las políticas del espacio, de acuerdo al concepto de foucaultiano de heterotopía. En primer lugar, se describe una breve genealogía de los usos de sustancias psicotrópicas en los diversos tiempos y culturas hasta la llegada del paradigma prohibicionista, atendiendo al modo en que el poder ha señalado, separado y encerrado determinados rituales y usos del placer en emplazamientos físicos y simbólicos. Este itinerario se centra en el contexto español para establecer un diálogo entre las distintas políticas del espacio que se han sucedido y superpuesto en la construcción y gestión de un problema que deviene objeto de la mirada, la mecánica y los discursos médicos, jurídicos y sociales. Así, se analizan las intersecciones de los emplazamientos liminares de consumo con el paradigma de la reducción de daños, así como las estrategias terapéuticas con prescripción farmacológica, desde los programas de metadona hasta los más recientes de heroína.This article traces a map of the social control of drugs through the politics of space, according to the Foucaultian concept of “heterotopia.” Firstly, a brief genealogy of the use of psychotropic substances in different times and cultures is described, up to the introduction of the prohibitionist paradigm. Attention is paid to the way in which power has marked, separated and enclosed certain rituals and uses of pleasure in physical and symbolic sites. The itinerary is focused on the Spanish context to establish a dialogue between the various policies of space that have come into being and have overlapped in the construction and management of a problem which has been rendered an object to the gazes, mechanics and discourses of the medical, legal, and social fields. In this way, the intersections between the liminal spaces of drug use and the harm reduction paradigm are analyzed, including therapeutic strategies with prescribed drugs, from methadone programs to the new heroin program
Cartografía de heterotopías psicoactivas: una mirada a los discursos médicos, jurídicos y sociales sobre los usos de drogas
This article traces a map of the social control of drugs through the politics of space, according to the Foucaultian concept of “heterotopia.” Firstly, a brief genealogy of the use of psychotropic substances in different times and cultures is described, up to the introduction of the prohibitionist paradigm. Attention is paid to the way in which power has marked, separated and enclosed certain rituals and uses of pleasure in physical and symbolic sites. The itinerary is focused on the Spanish context to establish a dialogue between the various policies of space that have come into being and have overlapped in the construction and management of a problem which has been rendered an object to the gazes, mechanics and discourses of the medical, legal, and social fields. In this way, the intersections between the liminal spaces of drug use and the harm reduction paradigm are analyzed, including therapeutic strategies with prescribed drugs, from methadone programs to the new heroin programsEste artículo traza un mapa del control social de las drogas a partir de las políticas del espacio, de acuerdo al concepto de foucaultiano de heterotopía. En primer lugar, se describe una breve genealogía de los usos de sustancias psicotrópicas en los diversos tiempos y culturas hasta la llegada del paradigma prohibicionista, atendiendo al modo en que el poder ha señalado, separado y encerrado determinados rituales y usos del placer en emplazamientos físicos y simbólicos. Este itinerario se centra en el contexto español para establecer un diálogo entre las distintas políticas del espacio que se han sucedido y superpuesto en la construcción y gestión de un problema que deviene objeto de la mirada, la mecánica y los discursos médicos, jurídicos y sociales. Así, se analizan las intersecciones de los emplazamientos liminares de consumo con el paradigma de la reducción de daños, así como las estrategias terapéuticas con prescripción farmacológica, desde los programas de metadona hasta los más recientes de heroína
«Un aleph en el callejón del gato. Espacio, cuerpo y ritual: una antropología de los tratamientos de heroína para la adicción a opiáceos en la biopolítica de la reducción de daños».
Desde los años noventa, ha habido un intenso debate médico, legal, político y mediático alrededor del uso de heroína como tratamiento de mantenimiento según el paradigma de reducción de daños, llegando a ensayarse en varios países de Europa y Norteamérica e institucionalizarse en algunos de ellos. En mi investigación, en primer lugar analizo los discursos científicos orientados a legitimar la prescripción de heroína para usuarios de drogas refractarios a los tratamientos de metadona. Después de una visión crítica sobre los modelos epistemológicos hegemónicos en este ámbito, justifico mi marco teórico para analizar los programas de heroína como una tecnología de poder. Así, mediante un sistema de tropos articulado en torno al espacio, el cuerpo y el ritual, en correspondencia con los conceptos de heterotopia (Foucault), ‘esperpento’ yonqui (Valle-Inclán) y ‘carnavalización’ (Bajtin), respectivamente, describo una cartografía y una anatomía del control de uso de drogas y la anormalidad de yonqui, que servirán de coordenadas para localizar políticamente los tratamientos de heroína. A raíz de mi propuesta interpretativa, presento un enfoque etnográfico en el centro de Prescripción Experimental de Estupefacientes de Andalucía (PEPSA) para estudiar la microfísica del poder dentro de esta estrategia de gubernamentalidad. A través de la estructura ritual que conforma este dispositivo clínico, analizo los procesos de subjetivación, incorporación y las resistencias experimentadas por los usuarios, de acuerdo a la perspectiva dialógica del encuentro terapéutico. Como conclusión, a pesar de los conflictos asociados a la liminaridad de esta tecnología, el ritual asistencial sirve de mecanismo performativo para transformar las identidades sociales de la mayoría de los usuarios, cumpliendo una función “re-generadora”.Since the nineties, there has been an intense medical, legal, political and media debate around the use of heroin as a maintenance treatment according to the harm reduction paradigm, reaching tested in several countries in Europe and North America and institutionalized in some of them. In my research, firstly I analyze the scientific discourses oriented to legitimate heroin prescription to methadone refractory drug users. After a critical view about the hegemonic epistemological models in this area, I justify my theoretical framework to analyze the heroin addiction treatments as a technology of power. So, through a system of tropes around the space, the body and ritual, in correspondence with the concepts of ‘heterotopia’ (Foucault), ‘esperpento’ junkie (Valle-Inclán) and ‘carnivalization’ (Bakhtin), respectively, I describe both a cartography and an anatomy of drug use control and yonqui abnormality, which will serve as coordinates to locate politically the heroin treatments. Following my interpretative proposal, an ethnographic approach to the Andalusian narcotics prescription centre (PEPSA) is presented to study the microphysics of power performed through this governmentality strategy. Though a ritual structure which shapes this clinical device, I analyze the processes of subjectivation, embodiment and resistances experienced by the users, framed within a dialogic perspective of the therapeutic encounter. In conclusion, despite the conflicts associated to the liminality of this technology, the ritual of care works as performative mechanism to transform the social identities for most users, accomplishing a “re-generative” function
Associations Between the Modified Food Standard Agency Nutrient Profiling System Dietary Index and Cardiovascular Risk Factors in an Elderly Population
Background: Helping consumers to improve the nutritional quality of their diet is
a key public health action to prevent cardiovascular diseases (CVDs). The modified
version of the Food Standard Agency Nutrient Profiling System Dietary Index (FSAm-
NPS DI) underpinning the Nutri-Score front-of-pack label has been used in public
health strategies to address the deleterious consequences of poor diets. This study
aimed to assess the association between the FSAm-NPS DI and some CVD risk
factors including body mass index (BMI), waist circumference, plasma glucose levels,
triglyceride levels, high-density lipoprotein (HDL) and low-density lipoprotein (LDL)
cholesterol, and diastolic and systolic blood pressure.
Materials and Methods: Dietary intake was assessed at baseline and after
1 year of follow-up using a 143-item validated semi-quantitative food-frequency
questionnaire. Dietary indices based on FSAm-NPS applied at an individual level were
computed to characterize the diet quality of 5,921 participants aged 55–75 years
with overweight/obesity and metabolic syndrome from the PREDIMED-plus cohort.
Associations between the FSAm-NPS DI and CVD risk factors were assessed using
linear regression models.
Results: Compared to participants with a higher nutritional quality of diet (measured by
a lower FSAm-NPS DI at baseline or a decrease in FSAm-NPS DI after 1 year), those
participants with a lower nutritional quality of diet (higher FSAm-NPS DI or an increase
in score) showed a significant increase in the levels of plasma glucose, triglycerides,
diastolic blood pressure, BMI, and waist circumference (b coefficient [95% confidence
interval]; P for trend) (1.67 [0.43, 2.90]; <0.001; 6.27 [2.46, 10.09]; <0.001; 0.56 [0.08,
1.05]; 0.001; 0.51 [0.41, 0.60]; <0.001; 1.19 [0.89, 1.50]; <0.001, respectively). No
significant associations in relation to changes in HDL and LDL-cholesterol nor with
systolic blood pressure were shown.
Conclusion: This prospective cohort study suggests that the consumption of food
items with a higher FSAm-NPS DI is associated with increased levels of several major
risk factors for CVD including adiposity, fasting plasma glucose, triglycerides, and
diastolic blood pressure. However, results must be cautiously interpreted because no
significant prospective associations were identified for critical CVD risk factors, such as
HDL and LDL-cholesterol, and systolic blood pressure.official Spanish InstitutionsEuropean Commission PI13/00673
PI13/00492
PI13/00272
PI13/01123
PI13/00462
PI13/00233
PI13/02184
PI13/00728
PI13/01090
PI13/01056
PI14/01722
PI14/00636
PI14/00618The European Regional Development Fund PI16/01120
PI17/00764
PI17/01183
PI17/00855
PI17/01347
PI17/00525
PI17/01827
PI17/00532
PI17/00215
PI17/01441
PI17/00508Especial Action Project entitled: Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-PlusEuropean Research Council (ERC)
European Commission 340918La Caixa Foundation 2013ACUP00194Junta de Andalucia PI0458/2013
PS0358/2016
PI0137/2018Center for Forestry Research & Experimentation (CIEF)European CommissionSEMERGEN grantICREA under the ICREA Academia programAgencia de Gestio d'Ajuts Universitaris de Recerca (AGAUR FI) 2021FI_B 00145Sara Borrell CD21/00045
PI20/00138
PI20/01532
PI20/00456
PI20/00339
PI20/00557
PI20/00886
PI20/01158
PI17/01732
PI17/00926
PI19/00957
PI19/00386
PI19/00309
PI19/01032
PI19/00576
PI19/00017
PI19/01226
PI19/00781
PI19/01560
PI19/01332
PI20/01802
PI14/00696
PI14/01206
PI14/01919
PI14/00853
PI14/01374
PI14/00972
PI14/00728
PI14/01471
PI16/00473
PI16/00662
PI16/01873
PI16/01094
PI16/00501
PI16/00533
PI16/00381
PI16/00366
PI16/0152
A Preliminary Study on the Safety of Elastography during Pregnancy: Hypoacusia, Anthropometry, and Apgar Score in Newborns
Transient or acoustic radiation force elastography (ARFE) is becoming the most extended
technology to assess cervical effacement, additionally to the Bishop test and conventional ultrasound.
However, a debate on the fetal safety has been opened due to the high intensity focused beam emitted
to produce shear waves. This work is aimed at providing preliminary data to assess clinical effects of
fetal exposure. A follow-up study in newborns of 42 women exposed to ARFE during pregnancy
was carried out to explore neonatal hypoacusia, Apgar test, and anthropometry. No hypoacusia
cases attributable to ARFE were observed. The Apgar test at five minutes scored normally in all the
newborns. Comparisons between anthropometric measurements showed no significant statistically
differences. The results preclude to state the harmfulness nor the safety of ARFE. However, given
the concern on the high level of energy and the potential risk of harmful bioeffects, larger studies
are recommended.Ministry of Education
DPI2017-85359-R
UNGR15-CE-3664
PI16/00339Carlos III Feder fundJunta de Andalucía
PIN-0030-2017
PI-0107-2017Spanish Government
TEC2014-57394-PMNat Scientific Unit of Excellence
UCE.PP2017.0
In Vivo Measurement of Cervical Elasticity on Pregnant Women by Torsional Wave Technique: A Preliminary Study
A torsional wave (TW) sensor prototype was employed to quantify stiffness of the cervix in
pregnant women. A cross-sectional study in a total of 18 women between 16 weeks and 35 weeks +
5 days of gestation was performed. The potential of TW technique to assess cervical ripening was
evaluated by the measurement of stiffness related to gestational age and cervical length. Statistically
significant correlations were found between cervical stiffness and gestational age (R2 = 0.370,
p = 0.0074, using 1 kHz waves and R2 = 0.445, p = 0.0250, using 1.5 kHz waves). A uniform
decrease in stiffness of the cervical tissue was confirmed to happen during the complete gestation.
There was no significant correlation between stiffness and cervical length. A stronger association
between gestational age and cervical stiffness was found compared to gestational age and cervical
length correlation. As a conclusion, TW technique is a feasible approach to objectively quantify the
decrease of cervical stiffness related to gestational age. Further research is required to evaluate the
application of TW technique in obstetric evaluations, such as prediction of preterm delivery and labor
induction failure.This research was funded by the Ministry of Education grant numbers DPI2017-83859-R,
DPI2014-51870-R and UNGR15-CE-3664, Ministry of Health grant numbers DTS15/00093 and PI16/00339, and
Junta de Andalucía grant numbers, PI-0107-2017 and PIN-0030-2017
A systematic review and meta‑analysis of weight loss in control group participants of lifestyle randomized trials
Randomized clinical trials (RCTs) of lifestyle modification have reported beneficial effects of
interventions, compared to control. Whether participation in the control group has benefits is
unknown. To determine whether control group participants experience weight loss during the course
of RCTs. After prospective registration (PROSPERO CRD42021233070), we conducted searches in
Medline, Scopus, Web of Science, Cochrane library and Clinicaltrials.gov databases from inception
to May 2021 without language restriction to capture RCTs on dietary advice or physical activity
interventions in adults with overweight, obesity or metabolic syndrome. Data extraction and study
quality assessment was performed by two independent reviewers. Weight loss in the control group,
i.e., the difference between baseline and post-intervention, was pooled using random effects model
generating mean difference and 95% confidence interval (CI). Heterogeneity was assessed using the I2
statistical test. Subgroup meta-analysis was performed stratifying by follow-up period, type of control
group protocols and high-quality studies. Among the 22 included studies (4032 participants), the risk
of bias was low in 9 (40%) studies. Overall, the controls groups experienced weight loss of − 0.41 kg
(95% CI − 0.53 to − 0.28; I2
= 73.5% p < 0.001). To identify a result that is an outlier, we inspected
the forest plot for spread of the point estimates and the confidence intervals. The magnitude of
the benefit was related to the duration of follow-up (− 0.51 kg, 95% CI − 0.68, − 0.3, for 1–4 months
follow-up; − 0.32 kg, 95% CI − 0.58, − 0.07, 5–12 months; − 0.20 kg, 95% CI − 0.49, 0.10, ≥ 12 months).
In high-quality studies we found an overall weight loss mean difference of − 0.16 (95% CI − 0.39,
0.09) with a considerable heterogeneity (
I2 = 74%; p < 0.000). Among studies including control group
in waiting lists and combining standard care, advice and material, no heterogeneity was found
(
I2 = 0%, p = 0.589) and (
I2 = 0%, p = 0.438); and the mean difference was − 0.84 kg (95% CI − 2.47, 0.80)
and − 0.65 kg (95% CI − 1.03, − 0.27) respectively. Participation in control groups of RCTs of lifestyle
interventions had a benefit in terms of weight loss in meta-analysis with heterogeneity. These
results should be used to interpret the benefits observed with respect to intervention effect in trials.
That control groups accrue benefits should be included in patient information sheets to encourage
participation in future trials among patients with overweight and obesity.Spanish Government PI20/01532Centro de Investigacion Biomedica en Red-Epidemiologia y Salud Publica CIBERESP/CB06/02/101
Benefits of Participation in Clinical Trials: An Umbrella Review
Participation in randomised clinical trials (RCTs) entails taking part in the discovery of
effects of health care interventions. The question of whether participants’ outcomes are different
to those of non-participants remains controversial. This umbrella review was aimed at assessing
whether there are health benefits of participation in RCTs, compared to non-participation. After
prospective registration (PROSPERO CRD42021287812), we searched the Medline, Scopus,Web of
Science and Cochrane Library databases from inception to June 2022 to identify relevant systematic
reviews with or without meta-analyses. Data extraction and study quality assessment (AMSTAR-2)
were performed by two independent reviewers. Of 914 records, six systematic reviews summarising
380 comparisons of RCT participants with non-participants met the inclusion criteria. In two reviews,
the majority of comparisons were in favour of participation in RCTs. Of the total of comparisons,
69 (18.7%) were in favour of participation, reporting statistically significant better outcomes for
patients treated within RCTs, 264 (71.7%) comparisons were not statistically significant, and 35 (9.5%)
comparisons were in favour of non-participation. None of the reviews found a harmful effect of
participation in RCTs. Our findings suggest that taking part in RCTs may be beneficial compared
to non-participation.Ministry of Science and Innovation, Instituto de Salud Carlos IIIFEDER co-funding from European Union PI20/01532Centro de Investigacion Biomedica en Red-Epidemiologia y Salud Publica CIBERESP/CB06/02/101
Performance Study of a Torsional Wave Sensor and Cervical Tissue Characterization
A novel torsional wave sensor designed to characterize mechanical properties of soft tissues is presented in this work. Elastography is a widely used technique since the 1990s to map tissue stiffness. Moreover, quantitative elastography uses the velocity of shear waves to achieve the shear stiffness. This technique exhibits significant limitations caused by the difficulty of the separation between longitudinal and shear waves and the pressure applied while measuring. To overcome these drawbacks, the proposed torsional wave sensor can isolate a pure shear wave, avoiding the possibility of multiple wave interference. It comprises a rotational actuator disk and a piezoceramic receiver ring circumferentially aligned. Both allow the transmission of shear waves that interact with the tissue before being received. Experimental tests are performed using tissue mimicking phantoms and cervical tissues. One contribution is a sensor sensitivity study that has been conducted to evaluate the robustness of the new proposed torsional wave elastography (TWE) technique. The variables object of the study are both the applied pressure and the angle of incidence sensor–phantom. The other contribution consists of a cervical tissue characterization. To this end, three rheological models have fit the experimental data and a static independent testing method has been performed. The proposed methodology permits the reconstruction of the mechanical constants from the propagated shear wave, providing a proof of principle and warranting further studies to confirm the validity of the results.This research was supported by the Ministry of Education DPI2014-51870-R, DPI2010-17065 and UNGR15-CE-3664, Ministry of Health DTS15/00093 and PI16/00339, and Junta de Andalucía P11-CTS-8089 projects. Modesto T. López-López acknowledges financial support by the project FIS2013-41821-R (Ministry of Economy and Competitiveness, co-funded by the ERDF, European Union). We acknowledge the collaboration of the members of the Anatomical Pathology Unit of the University Hospital Complex of Granada. Finally, Antonio Callejas is grateful to the University of Granada for the award of an PhD fellowship
Associations Between the Modified Food Standard Agency Nutrient Profiling System Dietary Index and Cardiovascular Risk Factors in an Elderly Population
Background: Helping consumers to improve the nutritional quality of their diet is a key public health action to prevent cardiovascular diseases (CVDs). The modified version of the Food Standard Agency Nutrient Profiling System Dietary Index (FSAm-NPS DI) underpinning the Nutri-Score front-of-pack label has been used in public health strategies to address the deleterious consequences of poor diets. This study aimed to assess the association between the FSAm-NPS DI and some CVD risk factors including body mass index (BMI), waist circumference, plasma glucose levels, triglyceride levels, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and diastolic and systolic blood pressure. Materials and Methods: Dietary intake was assessed at baseline and after 1 year of follow-up using a 143-item validated semi-quantitative food-frequency questionnaire. Dietary indices based on FSAm-NPS applied at an individual level were computed to characterize the diet quality of 5,921 participants aged 55-75 years with overweight/obesity and metabolic syndrome from the PREDIMED-plus cohort. Associations between the FSAm-NPS DI and CVD risk factors were assessed using linear regression models. Results: Compared to participants with a higher nutritional quality of diet (measured by a lower FSAm-NPS DI at baseline or a decrease in FSAm-NPS DI after 1 year), those participants with a lower nutritional quality of diet (higher FSAm-NPS DI or an increase in score) showed a significant increase in the levels of plasma glucose, triglycerides, diastolic blood pressure, BMI, and waist circumference (beta coefficient [95% confidence interval]; P for trend) (1.67 [0.43, 2.90]; <0.001; 6.27 [2.46, 10.09]; <0.001; 0.56 [0.08, 1.05]; 0.001; 0.51 [0.41, 0.60]; <0.001; 1.19 [0.89, 1.50]; <0.001, respectively). No significant associations in relation to changes in HDL and LDL-cholesterol nor with systolic blood pressure were shown. Conclusion: This prospective cohort study suggests that the consumption of food items with a higher FSAm-NPS DI is associated with increased levels of several major risk factors for CVD including adiposity, fasting plasma glucose, triglycerides, and diastolic blood pressure. However, results must be cautiously interpreted because no significant prospective associations were identified for critical CVD risk factors, such as HDL and LDL-cholesterol, and systolic blood pressure