Book review: New pandemics, old politics: two hundred years of war on disease and its alternatives by Alex de Waal

In New Pandemics, Old Politics: Two Hundred Years of War on Disease and its Alternatives, Alex de Waal offers a new political history of epidemics, identifying and critiquing a repeated mobilisation of the ‘war metaphor’ of pandemic disease to show our persistent (mis-)framing of biological illness. The book is an extremely comprehensive and fascinating history of previous epidemics, their metaphors and manifestations, and a highly thought-provoking read in our current times, writes Hannah Farrimond. New Pandemics, Old Politics: Two Hundred Years of War on Disease and its Alternatives. Alex de Waal. Polity. 2021

A typology of vaping: Identifying differing beliefs, motivations for use, identity and political interest amongst e-cigarette users

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Background: The aim of this study was to identify and differentiate socially shared accounts of e-cigarette use (vaping) using Q-methodology, combining factor analysis with qualitative comments. Methods: Seventy statements on e-cigarettes, drawn from media, academic and online discussions, were sorted by participants along a continuum of agreement/disagreement, commenting on strongly ranked items. Each participant thus created their own ‘account’ of their vaping. A by-person correlation matrix of the sorts was conducted, then factor analysed, to identify similar accounts (p<0.01). Fifty-five UK vapers participated by post, 55% male, mean age of 46, 84% only vaping/16% vaping and smoking, 95% vaping daily. Results: Three accounts of e-cigarettes were identified. The first two were associated with having quit smoking; the third with ongoing tobacco smoking and vaping. In Factor One, ‘Vaping as Pleasure’, vaping was characterized as enjoyable, with long-term use envisaged and a medical model of vaping rejected. Factor One participants also held a strong vaping identity and were politically motivated to maintain the rights of adults to vape. In Factor Two, ‘Vaping as Medical Treatment’, vaping was understood as a pragmatic choice about how to medicate one’s smoking addiction, with the aim being to treat and ultimately reduce nicotine dependence. In Factor Three, ‘Ambivalent E-Cigarette Use’, participants reported fewer benefits and harboured more negative beliefs about e-cigarettes; they also strongly rejected a vaper identity, having no interest in online forums or being labelled a ‘vaper’ themselves. Conclusion: The UK e-cigarette users in this sample were not a homogeneous group; differing in their beliefs, motivations for use, identity and political interest. In particular they diverged on whether they accepted a medicalized account of vaping and identified as a vaper. Public health messages targeted to one group of e-cigarette users may not resonate with others.This work was funded by the University of Exeter research allowance

The ethics of research

This is the author accepted manuscript. The final version is available from Sage via the link in this record.Doing ethical research is a fundamentally important part of educational academic practice. Behaving ‘well’ in relation to your participants is not a new phenomenon. However, more recently, a more formal culture of ethics review through Institutional Review Boards (IRB’s) and Research Ethics Committees (REC’s) has emerged which has put the ethics of education research in the spotlight and, at times, questioned conventions of practice. It has been common-place in education research, for example, for teachers/lecturers to give out surveys to their students to assess pedagogical issues. However this raises questions of whether consent of students is full and free if no real option to ‘opt-out’ is provided. Similarly, university/college education students often go into schools to undertake projects with school children and are assured by those in authority that ‘everyone wants to take part’. Again, this raises questions about the power relationship between researchers, gatekeepers and the children involved- shouldn’t children, like adults, also be allowed to say ‘no’ to being researched

Ritual and Narrative in the Contemporary Anglican Wedding

Contemporary wedding ritual is a little-explored area of both the Christian theology and the English social reality of marriage. As persistently important rituals in contemporary England, weddings are of great interest in any attempt to describe and account for the place of ritual in contemporary life. As events which are simultaneously acts of Christian worship, efficacious legal ceremonies and popular cultural rites, Anglican weddings bring into focus numerous issues about the inter-relation of social and religious institutions and experiences, theological responses to contemporary culture, material culture and the defining and mapping of personal relationships. The central part of the research consists of a close, empirical study of weddings in the Church of England. This includes semi-structured interviews with marrying couples and officiating clergy, and observation of weddings and wedding rehearsals. This research was conducted within one deanery in West Yorkshire in 2006 and 2007. Theories of ritual, including rites of passage, and of performance are critically employed to examine the structure and function of wedding ritual, and the way in which specifically Christian ritual is incorporated into and informs a more complex ritual whole. Narrative, an increasingly important interpretative concept in both theology and the social sciences, is also employed as an analytical tool to examine both the way individuals make sense of their own experiences and actions. In addition to a detailed account of contemporary practice, weddings are shown to offer important insights into pastoral and liturgical practice and the ministerial identity of clergy. Moreover, weddings are revealed as vital events in contemporary social life, consolidating and displaying the socially embedded identity of marrying couples

Developing E-cigarette friendly smoking cessation services in England: staff perspectives

This is the final version of the article. Available from BioMed Central via the DOI in this record.BACKGROUND: Public health leadership in England has taken a distinctive international stance by identifying the potential public health benefit of e-cigarettes for smoking cessation. This includes the development of a ground-breaking set of national guidelines for developing e-cigarette friendly stop smoking services. However, little is known about the views of staff engaged within these services and whether or how such services are becoming e-cigarette friendly. This study aimed to investigate the uptake and usage of e-cigarette guidance, from the perspective of those enacting tobacco cessation interventions 'on the ground'. METHODS: Qualitative semi-structured interviews were conducted with 25 cessation service staff, including advisors (n = 15), managers (n = 5) and commissioners (n = 5) from eight different services in the South-West of England, UK. A thematic analysis of the transcripts was conducted using NVivo software. RESULTS: Although some stop smoking services labelled themselves e-cigarette friendly, there was no consensus over what this should entail. For some, this meant active engagement, such as working with local vape shops, and in the case of one service, offering e-cigarettes through a voucher scheme to disadvantaged groups. For others, an e-cigarette friendly service was conceptualized in a passive sense, as one which welcomed service users using e-cigarettes. Many services did not use the 'e-cigarette friendly' claim in their branding or promotional material. Several discursive themes underlay differing staff attitudes. Those more reluctant to engage framed this in terms of their 'duty of care', with concerns focusing on the addictiveness of nicotine, lack of medically licensed product and ongoing scientific controversy. Those motivated to engage drew on a discourse of social justice goals and 'doing things differently' in relation to lower socio-economic status smokers, those with mental health issues and other vulnerable groups. Strong public health leadership was also identified as a key factor in changing staff attitudes towards e-cigarettes. CONCLUSIONS: On-the-ground enactment of e-cigarette friendly services is varied as well as reflective of the wider policy and regulatory environment. Although the context of English stop smoking services is one of austerity and change, there are opportunities for active engagement with e-cigarettes to achieve overall cessation goals. For this to occur, training, policy consistency and sharing best practice are needed.This study was funded by Cancer Research UK, Tobacco Advisory Group (TAG)

Being a smoker': Investigating smoking identities in different socio-economic groups in England.

Smoking is strongly linked to disadvantage (Jarvis & Wardle, 1999). Psychological approaches to studying the 'poor smoker' have tended to neglect potentially important 'macro-social' factors. This thesis takes a social psychological approach, focused on social identity (Campbell, 1997). It aims to consider the construction of identities and meaning-systems amongst different socio-economic status groups in England. Two studies were undertaken, representing a mixed methodological approach. In the first study, smokers and non-smokers from higher and lower socio-economic groups were given a conceptual map task to capture their spontaneous associations with the topic. This was followed by an in-depth interview. A thematic analysis showed that smokers were identified as 'unhealthy, stressed out and addicted'. They were also identified with 'Other' already stigmatised groups such as the old, the young and working-class groups. Non-smokers emphasised a moral discourse surrounding smoking to draw boundaries between themselves and 'bad' smokers. Higher SES smokers tended to distance themselves from the negative dimensions of smoking identities, whereas lower SES tended to internalise them. The second study was a Q-methodological one, comprising a sample of smokers from different SES groups. A six-factor model of 'smoking identities' was generated. Three identities oriented around a biomedical model of smoking as an addictive health risk. The other three reflected alternative or paradoxical constructions of smoking based on pleasure, freedom and the rights of smokers. It is concluded that taking into account smoking identities and the conceptual understandings underlying them offers the opportunity to locate health promotion where the audience is thinking (Joffe, 2002). This is particularly important when targeting lower SES smokers

Memantine and cholinesterase inhibitor combination therapy for Alzheimer's disease: a systematic review

BACKGROUND: Memantine is licensed for moderate-to-severe Alzheimer's disease (AD). National Institute for Clinical Excellence (NICE) guidance does not recommend the use of memantine in combination with cholinesterase inhibitors (acetylcholinesterase inhibitor (AChEI)). The underpinning meta-analysis was disputed by the manufacturer. OBJECTIVES: To compare the efficacy of AChEI monotherapy with combination memantine and AChEI therapy in patients with moderate-to-severe AD and to examine the impact of including unpublished data on the results. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: The Cochrane Dementia Group trial register, ALOIS, searched for the last time on 3 May 2011. DATA SYNTHESIS: Data from four domains (clinical global, cognition, function, behaviour and mood) were pooled. Sensitivity analyses examined the impact on the NICE-commissioned meta-analysis of restricting data to patients with moderate-to-severe AD and of including an unpublished trial of an extended release preparation of memantine. RESULTS: Pooled data from the trials, which were included in the NICE-commissioned meta-analysis but which were restricted to moderate-to-severe AD only, showed a small effect of combination therapy on cognition (standardised mean difference (SMD)=-0.29, 95% CI -0.45 to -0.14). Adding data from an unpublished trial of an extended release memantine (total three trials, 1317 participants) showed a small benefit of combination therapy on global scores (SMD=-0.20, 95% CI -0.31 to -0.09), cognition (SMD=-0.25, 95% CI -0.36 to -0.14) and behaviour and mood (SMD=-0.17, 95% CI -0.32 to -0.03) but not on function (SMD=-0.04, 95% CI -0.21 to 0.13) at 6 months. No clinical data have been reported from a 1-year trial, although this found 'no significant benefit' on any clinical measures at 1 year. CONCLUSIONS: These results suggest that there may be a small benefit at 6 months of adding memantine to AChEIs. However, the impact on clinical global impression depends on exactly which studies are included, and there is no benefit on function, so its clinical relevance is not robustly demonstrated. Currently available information from randomised controlled trails indicates no benefit of combination therapy over monotherapy at 1 year. Legislation on the form and content of registry posted results is needed in Europe

‘Being a horror fan and being a feminist are often a conflicting business’: feminist horror, the opinion economy and Teeth’s gendered audiences

Horror has long been understood as a ‘bad object’ in relation to its audiences. More specifically, this presumed relationship is a gendered one, so that men are positioned as the genre’s natural audience, while women’s engagement with horror is presented as more fractious. However, those horror films framed as feminist require a reorientation of these relations. This article foregrounds the critical reception of a ‘conspicuously feminist’ horror film in order to explore what happens to the bad object of horror within an opinion economy that works to diagnose the feminism or its absence in popular culture. Reviews of Teeth (2007), a ‘feminist horror film’ about vagina dentata, illustrate the push and pull of gendered power attached to feminist media, where empowerment is often understood in binary terms in relation to its gendered audiences. The assumed disempowerment of male audiences takes precedence in many reviews, while other narratives emerge in which Teeth becomes an educational tool that might change gendered behaviours, which directly empowers female audiences or which dupes women into believing they have been empowered. Finally, Teeth’s reviews expose a language of desire and fantasy around vagina dentata as an automated solution to the embodied experiences of women in contemporary culture. Teeth’s reviews, I argue, offer a valuable case study for interrogating the tensions in discourse when the bad object of horror is put to work for feminism

Cannabinol and cannabidiol exert opposing effects on rat feeding patterns

Rationale: Increased food consumption following Δ9- tetrahydrocannabinol-induced cannabinoid type 1 receptor agonism is well documented. However, possible non-Δ9- tetrahydrocannabinol phytocannabinoid-induced feeding effects have yet to be fully investigated. Therefore, we have assessed the effects of the individual phytocannabinoids, cannabigerol, cannabidiol and cannabinol, upon feeding behaviors. Methods: Adult male rats were treated (p.o.) with cannabigerol, cannabidiol, cannabinol or cannabinol plus the CB1R antagonist, SR141716A. Prior to treatment, rats were satiated and food intake recorded following drug administration. Data were analyzed for hourly intake and meal microstructure. Results: Cannabinol induced a CB1R-mediated increase in appetitive behaviors via significant reductions in the latency to feed and increases in consummatory behaviors via increases in meal 1 size and duration. Cannabinol also significantly increased the intake during hour 1 and total chow consumed during the test. Conversely, cannabidiol significantly reduced total chow consumption over the test period. Cannabigerol administration induced no changes to feeding behavior. Conclusion: This is the first time cannabinol has been shown to increase feeding. Therefore, cannabinol could, in the future, provide an alternative to the currently used and psychotropic Δ9-tetrahydrocannabinol-based medicines since cannabinol is currently considered to be non-psychotropic. Furthermore, cannabidiol reduced food intake in line with some existing reports, supporting the need for further mechanistic and behavioral work examining possible anti-obesity effects of cannabidiol

Stigma mutation: Tracking lineage, variation and strength in emerging COVID-19 stigma.

This is the final version. Available from SAGE Publications via the DOI in this record. In this article, I propose a novel theoretical framework for conceptualizing pandemic stigma using the metaphor of 'mutation'. This metaphor highlights that stigma is not a static or fixed state but is enacted through processes of continuity and change. The following three orienting concepts are identified: (a) lineage (i.e. origin narratives and initial manifestations are created in relation to existing stigmas, stereotypes, and outgroups), (b) variation (i.e. stigma changes over time in response to new content and contexts), and (c) strength (i.e. stigma can be amplified or weakened through counter- or de-stigmatizing forces). I go on to use this metaphor to offer an analysis of the emergence of COVID-19 stigma. The lineage of COVID-19 stigma includes a long history of contagious disease, resonant with fears of contamination and death. Origin narratives have stigmatized Asian/Chinese groups as virus carriers, leading to socio-political manifestations of discrimination. Newer 'risky' groups have emerged in relation to old age, race and ethnicity, poverty, and weight, whose designation as 'vulnerable' simultaneously identifies them as victims in need of protection but also as a risk to the social body. Counter-stigmatizing trends are also visible. Public disclosure of having COVID-19 by high-status individuals such as the actor Tom Hanks has, in some instances, converted 'testing positive' into shared rather than shamed behaviour in the West. As discourses concerning risk, controllability, and blame unfold, so COVID-19 stigma will further mutate. In conclusion, the metaphor of mutation, and its three concepts of lineage, variation, and strength, offers a vocabulary through which to articulate emergent and ongoing stigma processes. Furthermore, the concept of stigma mutation identifies a clear role for social scientists and public health in terms of process engagement; to disrupt stigma, remaking it in less deadly forms or even to prevent its emergence altogether