Performing Anti-Nationalism: Solidarity, Glitter, and No Borders Politics with the Europa Europa Cabaret

The Europa Europa anti-nationalist cabaret was created in the run up to the 2014 Swedish elections by the Ful collective in collaboration with ‘house band’ the Knife. Part rally and part concert, Europa Europa responds to the Swedish Democrat Party’s anti-immigrant propaganda specifically and the migration policies of the European Union more generally, by enacting a kind of ‘no borders’ politics in a moment of rising nationalisms. The cabaret aims to build a temporary coalition between different but like-minded audiences as an aim distinct from changing minds. This solidarity is also practiced by the performers onstage, who use the ambiguous theatrical positioning of migration stories to challenge conventional imaginaries of heroes and criminals. Through Europa Europa and its inheritances, from historical agitprop to the Macarena, this essay extends performance’s repertoire as a form in which to practice strategic anti-nationalism, and to engage with friction in the process

The Subcutaneous Air-Pouch Model of Synovium and the Inflammatory Response to Heat Aggregated Gammaglobulin

Subcutaneous injection of sterile air in rodents results in the formation of an air pouch with a lining morphologically similar to synovium (Edwards et al., 1981). We extended the comparison between pouch and synovial tissue and confirmed broad similarities in structure and function but also noted important differences. The air pouch was used to study the time course of the acute inflammatory response to heat aggregated human IgG. Saline washout of the pouch allowed simultaneous measurement of cellular and mediator components of the inflammatory exudate. The aggregates were rapidly phagocytosed by the pouch lining cells, resulting in acute inflammation characterised by polymorphonuclear leucocyte infiltration with peak numbers in the exudate at 12 hours, temporally dissociated from the earlier peak of PGE2 at 3 hours

Interrogating trans and sexual identities through the conceptual lens of translocational positionality

This article explores the confluence of trans identity and sexuality drawing on the concept of translocational positionality. In this discussion, a broad spectrum of gendered positionalities incorporates trans identity which, in turn, acknowledges normative male and female identities as well as non-binary ones. It is also recognised, however, that trans identity overlaps with other positionalities (pertaining to sexuality, for example) to shape social location. In seeking to understand subject positions, a translocational lens acknowledges the contextuality and temporality of social categories to offer an analysis which recognises the overlaps and differentials of co-existing positionalities. This approach enables an analysis which explores how macro, or structural, contexts shape agency (at the micro-level) and also how both are mediated by trans people's multiple and shifting positionalities. In this framing, positionality represents a meso layer between structure and agency. Four case studies are presented using data from a qualitative study which explored trans people's experiences of family, intimacy and domestic abuse. We offer an original contribution to the emerging knowledge-base on trans sexuality by presenting data from four case studies. We do so whilst innovatively applying the conceptual lens of translocational positionality to an analysis which considers macro, meso and micro levels of influence

Care planning: a neoliberal three card trick

Introduction The three card game, sometimes called find the queen, is a classic confidence trick, typically taking place on an impromptu table top, set up on pavement or street corner. The tricksters usually operate in teams, pulling in punters and ‘losing’ games with their fellows to persuade prospective speculators the game is winnable. For our titular purposes the three card trick serves as a metaphor for broader deceits. We are concerned with how well-meaning mental health nurses can enter into a set of apparently rational practices, insisted upon by policy and protocol, seemingly motivated by ideals of care and protection from harm, yet functioning to destroy the very essence of what it might mean to be a caring, progressive practitioner by contributing to a mutuality of alienation that, at the relational level, is the opposite of what services intend to achieve. This may prove to be the case because an external confidence trickster (neoliberalism) is actually in charge, and the real function of the game serves other ends. The whole point of the game is that genuine players can never win, and for the trickster to triumph it is necessary that these punters are willing, gullible and in most circumstances accept losses without too much fuss. When the losers do not go quietly this is referred to in the argot of the con as ‘squawking’, and personnel are deployed on the periphery to ensure any squawk is minimised. Various strategies can be used to ‘cool out the mark’, and are analogous to the means by which people are assisted to adjust to life’s disappointments in other contexts, including encounters with priests or sundry psy-professionals (Goffman 1952; McKeown et al. 2013). This commentary paper seeks to provoke nursing out of its state of gullibility and self-deception even if this involves painful reflection on the losses inherent in our collective game of mental health care. If we are to defend the importance of mental health nursing we must think more critically about our complicity within oppressive systems of control and do something about it. There is a lengthy critical tradition to draw on. We urge mental health nurses to squawk, asserting a more recalcitrant and rebellious standpoint, preferably in alliance with service users, refusers and survivors. Acknowledging the constraints upon nursing’s agency, deficits of power, and structural disadvantage need not default to impotence and inaction: collective resistance is always possible, however difficult the circumstances

Absolute risk representation in cardiovascular disease prevention: comprehension and preferences of health care consumers and general practitioners involved in a focus group study

Background Communicating risk is part of primary prevention of coronary heart disease and stroke, collectively referred to as cardiovascular disease (CVD). In Australia, health organisations have promoted an absolute risk approach, thereby raising the question of suitable standardised formats for risk communication. Methods Sixteen formats of risk representation were prepared including statements, icons, graphical formats, alone or in combination, and with variable use of colours. All presented the same risk, i.e., the absolute risk for a 55 year old woman, 16% risk of CVD in five years. Preferences for a five or ten-year timeframe were explored. Australian GPs and consumers were recruited for participation in focus groups, with the data analysed thematically and preferred formats tallied. Results Three focus groups with health consumers and three with GPs were held, involving 19 consumers and 18 GPs. Consumers and GPs had similar views on which formats were more easily comprehended and which conveyed 16% risk as a high risk. A simple summation of preferences resulted in three graphical formats (thermometers, vertical bar chart) and one statement format as the top choices. The use of colour to distinguish risk (red, yellow, green) and comparative information (age, sex, smoking status) were important ingredients. Consumers found formats which combined information helpful, such as colour, effect of changing behaviour on risk, or comparison with a healthy older person. GPs preferred formats that helped them relate the information about risk of CVD to their patients, and could be used to motivate patients to change behaviour. Several formats were reported as confusing, such as a percentage risk with no contextual information, line graphs, and icons, particularly those with larger numbers. Whilst consumers and GPs shared preferences, the use of one format for all situations was not recommended. Overall, people across groups felt that risk expressed over five years was preferable to a ten-year risk, the latter being too remote. Conclusions Consumers and GPs shared preferences for risk representation formats. Both groups liked the option to combine formats and tailor the risk information to reflect a specific individual's risk, to maximise understanding and provide a good basis for discussion

Psychosocial interventions for supporting women to stop smoking in pregnancy

Background: Tobacco smoking remains one of the few preventable factors associated with complications in pregnancy, and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and is increasing in low- to middle-income countries. Objectives: To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes. Search methods: In this sixth update, we searched the Cochrane Pregnancy and Childbirth Group's Trials Register (13 November 2015), checked reference lists of retrieved studies and contacted trial authors. Selection criteria: Randomised controlled trials, cluster-randomised trials, and quasi-randomised controlled trials of psychosocial smoking cessation interventions during pregnancy. Data collection and analysis: Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, with meta-regression conducted in STATA 14. Main results: The overall quality of evidence was moderate to high, with reductions in confidence due to imprecision and heterogeneity for some outcomes. One hundred and two trials with 120 intervention arms (studies) were included, with 88 trials (involving over 28,000 women) providing data on smoking abstinence in late pregnancy. Interventions were categorised as counselling, health education, feedback, incentives, social support, exercise and dissemination. In separate comparisons, there is high-quality evidence that counselling increased smoking cessation in late pregnancy compared with usual care (30 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.73) and less intensive interventions (18 studies; average RR 1.25, 95% CI 1.07 to 1.47). There was uncertainty whether counselling increased the chance of smoking cessation when provided as one component of a broader maternal health intervention or comparing one type of counselling with another. In studies comparing counselling and usual care (largest comparison), it was unclear whether interventions prevented smoking relapse among women who had stopped smoking spontaneously in early pregnancy. However, a clear effect was seen in smoking abstinence at zero to five months postpartum (11 studies; average RR 1.59, 95% CI 1.26 to 2.01) and 12 to 17 months (two studies, average RR 2.20, 95% CI 1.23 to 3.96), with a borderline effect at six to 11 months (six studies; average RR 1.33, 95% CI 1.00 to 1.77). In other comparisons, the effect was unclear for most secondary outcomes, but sample sizes were small. Evidence suggests a borderline effect of health education compared with usual care (five studies; average RR 1.59, 95% CI 0.99 to 2.55), but the quality was downgraded to moderate as the effect was unclear when compared with less intensive interventions (four studies; average RR 1.20, 95% CI 0.85 to 1.70), alternative interventions (one study; RR 1.88, 95% CI 0.19 to 18.60), or when smoking cessation health education was provided as one component of a broader maternal health intervention. There was evidence feedback increased smoking cessation when compared with usual care and provided in conjunction with other strategies, such as counselling (average RR 4.39, 95% CI 1.89 to 10.21), but the confidence in the quality of evidence was downgraded to moderate as this was based on only two studies and the effect was uncertain when feedback was compared to less intensive interventions (three studies; average RR 1.29, 95% CI 0.75 to 2.20). High-quality evidence suggests incentive-based interventions are effective when compared with an alternative (non-contingent incentive) intervention (four studies; RR 2.36, 95% CI 1.36 to 4.09). However pooled effects were not calculable for comparisons with usual care or less intensive interventions (substantial heterogeneity, I2 = 93%). High-quality evidence suggests the effect is unclear in social support interventions provided by peers (six studies; average RR 1.42, 95% CI 0.98 to 2.07), in a single trial of support provided by partners, or when social support for smoking cessation was provided as part of a broader intervention to improve maternal health. The effect was unclear in single interventions of exercise compared to usual care (RR 1.20, 95% CI 0.72 to 2.01) and dissemination of counselling (RR 1.63, 95% CI 0.62 to 4.32). Importantly, high-quality evidence from pooled results demonstrated that women who received psychosocial interventions had a 17% reduction in infants born with low birthweight, a significantly higher mean birthweight (mean difference (MD) 55.60 g, 95% CI 29.82 to 81.38 g higher) and a 22% reduction in neonatal intensive care admissions. However the difference in preterm births and stillbirths was unclear. There did not appear to be adverse psychological effects from the interventions. The intensity of support women received in both the intervention and comparison groups has increased over time, with higher-intensity interventions more likely to have higher-intensity comparisons, potentially explaining why no clear differences were seen with increasing intervention intensity in meta-regression analyses. Among meta-regression analyses: studies classified as having 'unclear' implementation and unequal baseline characteristics were less effective than other studies. There was no clear difference between trials implemented by researchers (efficacy studies), and those implemented by routine pregnancy staff (effectiveness studies), however there was uncertainty in the effectiveness of counselling in four dissemination trials where the focus on the intervention was at an organisational level. The pooled effects were similar in interventions provided for women classified as having predominantly low socio-economic status, compared to other women. The effect was significant in interventions among women from ethnic minority groups; however not among indigenous women. There were similar effect sizes in trials with biochemically validated smoking abstinence and those with self-reported abstinence. It was unclear whether incorporating use of self-help manuals or telephone support increased the effectiveness of interventions. Authors' conclusions: Psychosocial interventions to support women to stop smoking in pregnancy can increase the proportion of women who stop smoking in late pregnancy and the proportion of infants born low birthweight. Counselling, feedback and incentives appear to be effective, however the characteristics and context of the interventions should be carefully considered. The effect of health education and social support is less clear. New trials have been published during the preparation of this review and will be included in the next update

Polyamory: Intimate practice, identity or sexual orientation?

Polyamory means different things to different people. While some consider polyamory to be nothing more than a convenient label for their current relationship constellations or a handy tool for communicating their willingness to enter more than one relationship at a time, others claim it as one of their core identities. Essentialist identity narratives have sustained recent arguments that polyamory is best understood as a sexual orientation and is as such comparable with homosexuality, heterosexuality or bisexuality. Such a move would render polyamory intelligible within dominant political and legal frameworks of sexual diversity. The article surveys academic and activist discussions on sexual orientation and traces contradictory voices in current debates on polyamory. The author draws on poststructuralist ideas to show the shortcomings of sexual orientation discourses and highlights the losses which are likely to follow from pragmatic definitions of polyamory as sexual orientation