The collaborative management of antipsychotic medication and its obstacles: A qualitative study

Antipsychotic medication is the primary treatment for psychotic conditions such as schizophrenia and schizoaffective disorders; nevertheless, its administration is not free from conflicts. Despite taking their medication regularly, 25-50% of patients report no benefits or perceive this type of treatment as an imposition. Following in the footsteps of a previous initiative in Quebec (Canada), the Gestion Autonome de la Médication en Santé Mentale (GAM), this article ethnographically analyses the main obstacles to the collaborative management of antipsychotics in Catalonia (Spain) as a previous step for the implementation of this initiative in the Catalan mental healthcare network. We conducted in-depth interviews with patients (38), family caregivers (18) and mental health professionals (19), as well as ten focus groups, in two public mental health services, and patients' and caregivers' associations. Data were collected between February and December 2018. We detected three main obstacles to collaboration among participants. First, different understanding of the patient's distress, either as deriving from the symptoms of the disorder (professionals) or the adverse effects of the medication (patients). Second, differences in the definition of (un)awareness of the disorder. Whereas professionals associated disorder awareness with treatment compliance, caregivers understood it as synonymous with self-care, and among patients 'awareness of suffering' emerged as a comprehensive category of a set of discomforts (i.e., symptoms, adverse effects of medication, previous admissions, stigma). Third, discordant expectations regarding clinical communication that can be condensed in the differences in meaning between the Spanish words 'trato' and 'tratamiento', where the first denotes having a pleasant manner and agreement, and the second handling and management. We conclude that these three obstacles pave the way for coercive practices and promote patients' de-subjectivation, named here as the 'total patient' effect. This study is the first GAM initiative in Europe

Unraveling reactionary care: the experience of mother-caregivers of adults with severe mental disorders in Catalonia

In most Mediterranean countries, people diagnosed with severe mental disorders (SMDs) are typically cared for by the mother, causing a significant burden on people in this family role. Based on a broader mental health participatory action and qualitative research carried out in Catalonia (Spain) of 12 in-depth interviews and 3 focus groups, this article analyses the mother-caregivers' experience in the domestic space. The results show that patients and caregivers are engaged in a relationship of 'nested dependencies', which create social isolation. This produces the conditions of 'reactionary care', practices that limit the autonomy of those affected and that reproduce forms of disciplinary psychiatric institutions. We conclude that both institutional violence derived from economic rationality and that which stems from the gender mandate feed off each other into the domestic sphere. This research argues for placing care at the center of clinical practice and shows the need to consider the structural forces shaping it

Looking at the city after 27F

En dos meses más habrá transcurrido un año desde el 27 de febrero, cuando un terremoto y tsunami asolaron varias regiones del país, dejando una secuela de destrucción, donde sin duda, las perdidas más relevantes se reflejan en la cifra de 524 fallecidos y 31 desaparecidos. Sabemos que es complejo evaluar las múltiples consecuencias, directas e indirectas, del 27F; no obstante, hemos querido hacer un recuento de las principales secuelas de la catástrofe en nuestra ciudad a dos meses de cumplirse el primer aniversario de la tragedia. Este trabajo abarca sólo una fracción del daño sufrido y básicamente se enfoca al análisis de algunos eventos que con el paso del tiempo, se transformaron en los hitos que han marcado el doloroso proceso de reconstrucción.In two months’ time it will be a year since the 27th of February (27F), when an earthquake and tsunami devastated several regions of the country, leaving its scars of destruction most strongly reflected in the 524 confirmed dead and 31 missing persons6. We are aware of the complexity of trying to assess the manifold direct and indirect consequences of 27F; nevertheless, we wished to recount the main aftereffects of the catastrophe in our city two months prior to the first anniversary of the tragedy. This study can only touch on a fraction of the damage suffered and basically focuses on analysing a number of events that, with time, have been transformed into landmarks during the painful process of reconstruction

From Data to Software to Science with the Rubin Observatory LSST

The Vera C. Rubin Observatory Legacy Survey of Space and Time (LSST) dataset will dramatically alter our understanding of the Universe, from the origins of the Solar System to the nature of dark matter and dark energy. Much of this research will depend on the existence of robust, tested, and scalable algorithms, software, and services. Identifying and developing such tools ahead of time has the potential to significantly accelerate the delivery of early science from LSST. Developing these collaboratively, and making them broadly available, can enable more inclusive and equitable collaboration on LSST science. To facilitate such opportunities, a community workshop entitled "From Data to Software to Science with the Rubin Observatory LSST" was organized by the LSST Interdisciplinary Network for Collaboration and Computing (LINCC) and partners, and held at the Flatiron Institute in New York, March 28-30th 2022. The workshop included over 50 in-person attendees invited from over 300 applications. It identified seven key software areas of need: (i) scalable cross-matching and distributed joining of catalogs, (ii) robust photometric redshift determination, (iii) software for determination of selection functions, (iv) frameworks for scalable time-series analyses, (v) services for image access and reprocessing at scale, (vi) object image access (cutouts) and analysis at scale, and (vii) scalable job execution systems. This white paper summarizes the discussions of this workshop. It considers the motivating science use cases, identified cross-cutting algorithms, software, and services, their high-level technical specifications, and the principles of inclusive collaborations needed to develop them. We provide it as a useful roadmap of needs, as well as to spur action and collaboration between groups and individuals looking to develop reusable software for early LSST science.Comment: White paper from "From Data to Software to Science with the Rubin Observatory LSST" worksho

From Data to Software to Science with the Rubin Observatory LSST

editorial reviewedThe Vera C. Rubin Observatory Legacy Survey of Space and Time (LSST) dataset will dramatically alter our understanding of the Universe, from the origins of the Solar System to the nature of dark matter and dark energy. Much of this research will depend on the existence of robust, tested, and scalable algorithms, software, and services. Identifying and developing such tools ahead of time has the potential to significantly accelerate the delivery of early science from LSST. Developing these collaboratively, and making them broadly available, can enable more inclusive and equitable collaboration on LSST science. To facilitate such opportunities, a community workshop entitled "From Data to Software to Science with the Rubin Observatory LSST" was organized by the LSST Interdisciplinary Network for Collaboration and Computing (LINCC) and partners, and held at the Flatiron Institute in New York, March 28-30th 2022. The workshop included over 50 in-person attendees invited from over 300 applications. It identified seven key software areas of need: (i) scalable cross-matching and distributed joining of catalogs, (ii) robust photometric redshift determination, (iii) software for determination of selection functions, (iv) frameworks for scalable time-series analyses, (v) services for image access and reprocessing at scale, (vi) object image access (cutouts) and analysis at scale, and (vii) scalable job execution systems. This white paper summarizes the discussions of this workshop. It considers the motivating science use cases, identified cross-cutting algorithms, software, and services, their high-level technical specifications, and the principles of inclusive collaborations needed to develop them. We provide it as a useful roadmap of needs, as well as to spur action and collaboration between groups and individuals looking to develop reusable software for early LSST science

Por una antropología política de la salud

In this article I present a series of reflections whose purpose is to advocate for a political anthropology of health, situated in the context of the anthropology produced in and/or about Chile. For this reason, I use two preliminary questions: one that delves into three scenes of (re)production of anthropological-medical knowledge; and another that points out the (relative) absences in Chilean political anthropology. I then describe some useful tools for conceptualizing the relations between health and politics from an ongoing research experience that addresses the political field of mental health in Chile. In the conclusions, I propose the need for a critical historical perspective in approaches to processes focusing on health and power from an anthropological perspective.En este artículo presento una serie de reflexiones cuyo fin es abogar por una antropología política de la salud, situada en el contexto de la antropología producida en y/o sobre Chile. Para tal propósito, empleo dos interrogantes preliminares: una que indaga en tres escenas de (re)producción del conocimiento antropológico-médico; y otra que remarca las ausencias temáticas (relativas) en la antropología política chilena. Luego, describo algunas herramientas útiles para conceptualizar las relaciones entre salud y política desde una experiencia de investigación en curso que aborda el campo político de la salud mental en Chile. En las conclusiones, planteo la necesidad de una perspectiva histórica crítica en los abordajes de los procesos que abordan la salud y el poder en clave antropológica

The aftermath of enforced disappearance and concealment.: A qualitative inquiry with families in Paine, Chile

Introduction:   The forced disappearance of peasants in the Paine commune, Chile, dates back to the first months after the coup in 1973. Ten years ago, as a result of a judicial investigation, the location of a mass grave was revealed to more than one hundred kilometers from the detention site. This finding allowed the identification of eleven detainees who disappeared by genetic methods, along with another five recognized from forensic archaeological evidence. Our main objective is to account for the aftermath of forced disappearance and the operation to conceal the bodies of three generations of relatives of disappeared detainees.   Methods:   Qualitative research: Case study, carried out between 2014 and 2015, with a total of 19 interviewees from three generations, belonging to six families from Paine. Semi-structured interviews were conducted, with two to three sessions per interviewee and three discussion groups, one for each generation.   Results:   The three generations face in a dissimilar way the slogan of where are they ?, as well as they attribute different meanings to the skeletal remains. It contrasts the "duty to recognize" of the first generation with the interpellation of the third generation through practices that vindicate the collective dimension of mourning. In the experiences of intergenerational dialogue, spaces of memory have taken center stage, in particular the location of the common grave. One of the relevant results of this investigation has been to give an account of the social experience of forensic identification.   Conclusions:   Family relationships do not convey an integrating story but rather what stands out is the emptiness of representation and intergenerational silences. Science, through DNA, offers statistical evidence of identification, but the decision is maintained in the individual jurisdiction of each family member. Comprehensive forensic work with the participation of archaeologists, anthropologists, dentists and other experts contributes to restoring the dignity of the victimized body

Mirar la ciudad después del 27F

En dos meses más habrá transcurrido un año desde el 27 de febrero, cuando un terremoto y tsunami asolaron varias regiones del país, dejando una secuela de destrucción, donde sin duda, las perdidas más relevantes se reflejan en la cifra de 524 fallecidos y 31 desaparecidos. Sabemos que es complejo evaluar las múltiples consecuencias, directas e indirectas, del 27F; no obstante, hemos querido hacer un recuento de las principales secuelas de la catástrofe en nuestra ciudad a dos meses de cumplirse el primer aniversario de la tragedia. Este trabajo abarca sólo una fracción del daño sufrido y básicamente se enfoca al análisis de algunos eventos que con el paso del tiempo, se transformaron en los hitos que han marcado el doloroso proceso de reconstrucción