The Covid-19 pandemic means that the running down of US Strategic Stockpile of medicines could not have come at a worse time

As pain relievers, opioids are a vital part of treating patients with Covid-19. But, as Katherine Pettus writes, the combination of reductions by the US of its buffer stock of opioids, and the chronically low stocks in 80 percent of the world, mean that patients are now abandoned in their hour of need. She urges governments to listen to guidance from UN agencies which calls for access to controlled medicines for the patients who need them

Characterizing High Entropy Alloys for Hypersonic Applications

In this paper, the properties of a new and broad class of materials, high entropy alloys (HEAs), were investigated and evaluated for hypersonic applications. The plan was to identify candidate hypersonic HEAs and model the high-temperature strength using new advanced material models that account for asymmetry and anisotropy characterized with available test data. After accessing a local database of HEAs and their material properties in collaboration with Dr. Gorsse et al., it was realized the knowledge of HEAs is currently very broad but lacks depth. While hundreds of HEAs have been created and tested, none so far have both sufficient data and the desired properties to more accurately model high-temperature strength. Further research is required to begin bringing HEAs into the world of constitutive modeling and simulation, which is the next step to real world applications. Several HEAs have been identified as having high potential for further research

Structural imperialism and the pandemic of untreated pain in the Asia Region

This paper takes a transdisciplinary genealogical approach to the current global lack availability of internationally controlled essential medicines in more than 80% of the world, with a particular focus on the Asia region. More than six decades after the Single Convention on Narcotic Drugs (SC), whose Parties were “concerned with the health and welfare of mankind,” had stipulated that these substancs are ‘indispensable’ for the relief of pain and suffering, experts report that while the global consumption of opioids has increased, the consumption in most Asian countries has not increased at the same rate and that access is significantly impaired by widespread over-regulation that continues to be pervasive across the region. The tragic irony of this situation is that traditional opium-based medicines used for millennia in the region are unavailable, inaccessible, and unaffordable in these erstwhile imperial peripheries where their botanical sources are plentiful but forbidden, while global pharmaceutical corporations peddle their expensive synthetic opioids — formulated in the metropolis — to formerly colonized populations who cannot afford them and whose health workers are largely untrained to prescribe them

Whiteness, scapegoating, and scarcity: medicalizing ‘the US Opioid Crisis’

This paper characterizes the successful civil lawsuits brought by sub-national units of government in the US against multinational pharmaceutical companies to recover the costs of public expenditures (goods and services) incurred as they attempt to manage the ‘opioid crisis,’ as a scapegoating strategy whose function is to deflect attention from the governance failures that allow corporate colonization of the public sphere and rescue the moribund privileges of whiteness enjoyed by the ‘blue collar aristocracy’ until neoliberal globalization rendered them obsolete. Recent drops in white life expectancy, which are associated with chronic diseases and non-medical opioid use, map onto high unemployment and under-employment rates in formerly prosperous communities, now fodder for populist political campaigns. Criminalizing the pharmaceutical companies and executives for peddling prescription medicines to inadequately trained (in the treatment of pain) physicians — some of whom prescribed opioids inappropriately to (majority white) patients/consumers, some of whom developed addictions, and/or poisoning following non-medical use or consumption with alcohol or illicit substances —medicalizes the white opioid crisis and identifies consumers as victims. This distinguishes them from the Americans of color whose ‘drug use’ has been criminalized, who have been disproportionately arrested, and sentenced to long periods of incarceration that entail the loss of civil and political rights, including the right to vote. White elites staked out the ‘color line’ before the Founding, perpetuating it through various scapegoating and ‘shapeshifting’ strategies to the present day. The lawsuits are only the most recent iteration of a morally bankrupt carceral state

The Challenges Facing Palliative Care Advocacy: What Is in a Name?

The need for Palliative Care (PC) continues to grow throughout the world, requiring continuous development, true to its “ethos.” As awareness grows so does the expectation for timely response and policies to potentiate its delivery. The scientific dimension of its philosophy, underpinned by research and scientific practice, looks to explain its nature, origin and concepts, models and theories within which it is delivered. The concept palliation is widely used; yet, it is understudied by academics and clinicians. Interestingly, it is increasingly questioned by society and other specialists, calling for it to “be debated and essentially contested”. Our aim is to contribute to society’s understanding of palliative care so that they can have a clear and truthful awareness of the complex implications of its mission. We approach the different concepts, scientific theories and structures can be achieved by following different pathways, including defining its “ethos”: personality or nature, manifest in the very formulae by which PC places itself before those who need it. What a fascinating topic it is to research and write on!, phenomenological in its base, it shows how different translations of the Anglo-Saxon PC influence its understanding and much needed expansion. Semiotics are at the base of the essence of how palliative care might be assumed and promoted. PC is, for sure, one of the most important, existential spheres to apply our knowledge today and a novel promising methodology to apply the semiotic and phenomenological approaches learning of different aspects of cultural transfer processes

International Association for Hospice and Palliative Care Position Statement: Euthanasia and Physician-Assisted Suicide

Background: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement. Purpose: To describe the position of the IAHPC regarding Euthanasia and PAS. Method: The IAHPC formed a working group (WG) of seven board members and two staff officers who volunteered to participate in this process. An online search was performed using the terms ‘‘position statement’’, ‘‘euthanasia’’ ‘‘assisted suicide’’ ‘‘PAS’’ to identify existing position statements from health professional organizations. Only statements from national or pan-national associations were included. Statements from seven general medical and nursing associations and statements from seven palliative care organizations were identified. A working document including a summary of the different position statements was prepared and based on these, an initial draft was prepared. Online discussions among the members of the WG took place for a period of three months. The differences were reconciled by email discussions. The resulting draft was shared with the full board. Additional comments and suggestions were incorporated. This document represents the final version approved by the IAHPC Board of Directors. Result: IAHPC believes that no country or state should consider the legalization of euthanasia or PAS until it ensures universal access to palliative care services and to appropriate medications, including opioids for pain and dyspnea. Conclusion: In countries and states where euthanasia and/or PAS are legal, IAHPC agrees that palliative care units should not be responsible for overseeing or administering these practices. The law or policies should include provisions so that any health professional who objects must be allowed to deny participatin

Redefining Palliative CaredA New Consensus-Based Definition

Context. The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. Objective. The main objective of this article is to present the research behind the new definition. Methods. The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. Results. The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. Conclusion. Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span