Healthcare choice: Discourses, perceptions, experiences and practices

Policy discourse shaped by neoliberal ideology, with its emphasis on marketisation and competition, has highlighted the importance of choice in the context of healthcare and health systems globally. Yet, evidence about how so-called consumers perceive and experience healthcare choice is in short supply and limited to specific healthcare systems, primarily in the Global North. This special issue aims to explore how choice is perceived and utilised in the context of different systems of healthcare throughout the world, where choice, at least in policy and organisational terms, has been embedded for some time. The articles are divided into those emphasising: embodiment and the meaning of choice; social processes associated with choice; the uncertainties, risks and trust involved in making choices; and issues of access and inequality associated with enacting choice. These sociological studies reveal complexities not always captured in policy discourse and suggest that the commodification of healthcare is particularly problematic

Critical perspectives on ‘consumer involvement’ in health research: epistemological dissonance and the know-do gap

Researchers in the area of health and social care (both in Australia and internationally) are encouraged to involve consumers throughout the research process, often on ethical, political and methodological grounds, or simply as ‘good practice’. This paper presents findings from a qualitative study in the UK of researchers’ experiences and views of consumer involvement in health research. Two main themes are presented in the paper. Firstly, we explore the ‘know-do gap’ which relates to the tensions between researchers’ perceptions of the potential benefits of, and their actual practices in relation to, consumer involvement. Secondly, we focus on one of the reasons for this ‘know-do gap’, namely epistemological dissonance. Findings are linked to issues around consumerism in research, lay/professional knowledges, the (re)production of professional and consumer identities and the maintenance of boundaries between consumers and researchers

Heterogeneous Agglomeration

Many prior treatments of agglomeration explicitly or implicitly assume that all industries agglomerate for the same reasons. This paper uses U.K. establishment-level coagglomeration data to document substantial heterogeneity across industries in the microfoundations of agglomeration economies. It finds robust evidence of organizational and adaptive agglomeration forces as discussed by Chinitz (1961), Vernon (1960), and Jacobs (1969). These forces interact with the traditional Marshallian (1890) factors of input sharing, labor pooling, and knowledge spillovers, establishing a previously unrecognized complementarity between the approaches of Marshall and Jacobs, as well as others, to the analysis of agglomeration

Home parenteral nutrition with an omega-3-fatty-acid-enriched MCT/LCT lipid emulsion in patients with chronic intestinal failure (the HOME study):study protocol for a randomized, controlled, multicenter, international clinical trial

BACKGROUND: Home parenteral nutrition (HPN) is a life-preserving therapy for patients with chronic intestinal failure (CIF) indicated for patients who cannot achieve their nutritional requirements by enteral intake. Intravenously administered lipid emulsions (ILEs) are an essential component of HPN, providing energy and essential fatty acids, but can become a risk factor for intestinal-failure-associated liver disease (IFALD). In HPN patients, major effort is taken in the prevention of IFALD. Novel ILEs containing a proportion of omega-3 polyunsaturated fatty acids (n-3 PUFA) could be of benefit, but the data on the use of n-3 PUFA in HPN patients are still limited. METHODS/DESIGN: The HOME study is a prospective, randomized, controlled, double-blind, multicenter, international clinical trial conducted in European hospitals that treat HPN patients. A total of 160 patients (80 per group) will be randomly assigned to receive the n-3 PUFA-enriched medium/long-chain triglyceride (MCT/LCT) ILE (Lipidem/Lipoplus® 200 mg/ml, B. Braun Melsungen AG) or the MCT/LCT ILE (Lipofundin® MCT/LCT/Medialipide® 20%, B. Braun Melsungen AG) for a projected period of 8 weeks. The primary endpoint is the combined change of liver function parameters (total bilirubin, aspartate transaminase and alanine transaminase) from baseline to final visit. Secondary objectives are the further evaluation of the safety and tolerability as well as the efficacy of the ILEs. DISCUSSION: Currently, there are only very few randomized controlled trials (RCTs) investigating the use of ILEs in HPN, and there are very few data at all on the use of n-3 PUFAs. The working hypothesis is that n-3 PUFA-enriched ILE is safe and well-tolerated especially with regard to liver function in patients requiring HPN. The expected outcome is to provide reliable data to support this thesis thanks to a considerable number of CIF patients, consequently to broaden the present evidence on the use of ILEs in HPN. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03282955. Registered on 14 September 2017

Gamma Ray Lines from a Universal Extra Dimension

Indirect Dark Matter searches are based on the observation of secondary particles produced by the annihilation or decay of Dark Matter. Among them, gamma-rays are perhaps the most promising messengers, as they do not suffer deflection or absorption on Galactic scales, so their observation would directly reveal the position and the energy spectrum of the emitting source. Here, we study the detailed gamma-ray energy spectrum of Kaluza--Klein Dark Matter in a theory with 5 Universal Extra Dimensions. We focus in particular on the two body annihilation of Dark Matter particles into a photon and another particle, which produces monochromatic photons, resulting in a line in the energy spectrum of gamma rays. Previous calculations in the context of the five dimensional UED model have computed the line signal from annihilations into \gamma \gamma, but we extend these results to include \gamma Z and \gamma H final states. We find that these spectral lines are subdominant compared to the predicted \gamma \gamma signal, but they would be important as follow-up signals in the event of the observation of the \gamma \gamma line, in order to distinguish the 5d UED model from other theoretical scenarios.Comment: 21 pages, 6 figure

A Bibliometric Analysis of Select Information Science Print and Electronic Journals in the 1990s

This paper examines three e-journals and one paper journal begun in the 1990s within the information science genre. In addition, these journals are compared to what is perhaps the leading information science journal, one that has been published continuously for fifty years. The journals we examine are CyberMetrics, Information Research, the Journal of Internet Cataloging, Libres, and the Journal of the American Society for Information Science. We find that there are a number of important differences among the journals. These include frequency of publication, publication size, number of authors, and the funding status of articles. We also find differences among journals for distributions of authors by gender and corporate authors by region. Some of the regional differences can be explained by journal maturation -- the more mature the journal the greater the dispersion. We also find that women are more likely to publish in the newer journals than in JASIS. The fact that a journal is or is not an e-journal does not appear to affect its presence or behaviour as an information science journal

Emerging treatment options for short bowel syndrome: potential role of teduglutide

INTRODUCTION: Current medical management of short bowel syndrome (SBS) involves the use of lifelong parenteral nutrition (PN). Glucagon-like peptide-2 (GLP-2), an important intestinotrophic growth factor has been shown to increase intestinal absorption in SBS through augmentation of post-resection intestinal adaptation. This may lead to the reduction of PN dependence in patients with SBS. AREAS COVERED IN REVIEW: Advancing research of GLP-2 physiology has spurred the growing understanding of the diverse effects of GLP-2. The development of the degradation resistant GLP-2 analog, teduglutide (Gattex(TM), NPS Pharmaceuticals, Bedminster, NJ), has allowed its exploration as a therapeutic agent in a variety of clinical settings. Recent multicenter, placebo-controlled studies of GLP-2 in SBS patients demonstrate meaningful reductions in PN requirements with good safety profiles. The reparative and immunomodulatory effects of teduglutide may also be beneficial in patients with inflammatory bowel disease (IBD). Safety concerns about possible carcinogenic properties during long-term use require ongoing evaluation. SUMMARY: GLP-2 appears to offer a novel adjuvant treatment modality for SBS. Promise for its use in other clinical settings like IBD has been shown in small pilot studies

TeV physics and the Planck scale

Supersymmetry is one of the best motivated possibilities for new physics at the TeV scale. However, both concrete string constructions and phenomenological considerations suggest the possibility that the physics at the TeV scale could be more complicated than the Minimal Supersymmetric Standard Model (MSSM), e.g., due to extended gauge symmetries, new vector-like supermultiplets with non-standard SU(2)xU(1) assignments, and extended Higgs sectors. We briefly comment on some of these possibilities, and discuss in more detail the class of extensions of the MSSM involving an additional standard model singlet field. The latter provides a solution to the $\mu$ problem, and allows significant modifications of the MSSM in the Higgs and neutralino sectors, with important consequences for collider physics, cold dark matter, and electroweak baryogenesis.Comment: 17 pages, 5 figures. To appear in New Journal of Physic