Futures-oriented drugs policy research: Events,trends, and speculating on what might become

One concern in the field of drugs policy is how to make research more futures-oriented. Tracing trends and events with the potential to alter drug futures are seen as ways of becoming more prepared. This challenge is made complex in fast evolving drug markets which entangle with shifting social and material relations at global scale. In this analysis, we argue that drugs policy research orientates to detection and discovery based on the recent past. This narrows future-oriented analyses to the predictable and probable, imagined as extensions of the immediate and local present. We call for a more speculative approach; one which extends beyond the proximal, and one which orientates to possibilities rather than probabilities. Drawing on ideas on speculation from science and technology and futures studies, we argue that speculative research holds potential for more radical alterations in drugs policy. We encourage research approaches which not only valorise knowing in relation to what might happen but which conduct experiments on what could be. Accordingly, we trace how speculative research makes a difference by altering the present through making deliberative interventions on alternative policy options, including policy scenarios which make a radical break with the present. We look specifically at the ‘Big Event’ and ‘Mega Trend’ as devices of speculative intervention in futures-oriented drugs policy research. We illustrate how the device of Mega Trend helps to trace as well as to speculate on some of the entangling elements affecting drug futures, including in relation to climate, environment, development, population, drug production, digitalisation, biotechnology, policy and discourse.     

Consequences of prematurity on adult morbidities

Early life events play a key role in the development of adult diseases. Survival is promoted by the developmental adaptation to environment although advantage in the short term implies a long-term cost with regard to the development of adult morbidities. This is particularly true for the infant born prematurely as preterm birth is accompanied by a disruption of the normal organogenesis of multiple organ systems.This review will examine the effect of prematurity on the development of cardiovascular, kidney, respiratory and metabolic diseases in later life in addition to the neurodevelopment disabilities associated with preterm birth.     

未婚女性青少年生殖健康治疗服务需求的调查研究

目的:了解未婚女性青少年生殖健康治疗服务的需求现状,为改善健康服务提供科学依据。方法:利用北京大学人口研究所中国青少年生殖健康可及性政策发展研究项目"2009年中国青少年生殖健康全国抽样调查"数据,选取其中关于青少年生殖健康服务需求相关的数据进行卡方检验和logistic分析。结果:共回收未婚女性青少年有效问卷10970份;在最近12个月中,女性青少年的治疗需求率为35.5。回归分析显示,青少年年龄越大、个人可支配收入越高,其生殖健康服务的需求越高;有宗教信仰、初中及以下文化水平的青少年需求较高;农村地区青少年的需求高于城镇青少年;中部地区和西部地区需求高于东部地区。结论:未婚女性青少年的生殖健康服务需求率较高,不同特征者需求不同。应为青少年提供多层次多角度的生殖健康服务保障,重点关注低文化水平、农村和西部地区青少年的服务需求;引导高收入、有性行为的青少年降低高风险行为,促进其生殖健康。     

Subsolid Lung Adenocarcinomas: Radiological,Clinical and Pathological Features and Outcomes

Radiological, clinical and pathological features and outcomes of subsolid lung adenocarcinomas.

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Coming ‘Home’: Place bonding for parents accessing or considering hospice based respite

Little literature examines the cognitive journey taken by parents considering/receiving hospice care for their child. A constructivist grounded theory study explored 38 parents' views of considering/using a children's hospice. Data analysed from focus groups and interviews identified three main concepts. The focus of this paper is identified as Coming ‘Home’. This concept depicts the desire and the sense of searching that parents experienced in trying to find a place, other than their actual home, where their child could access a caring environment and their parents received some respite from caregiving. Despite there being a paradox associated with hospice-based respite, once they had crossed the threshold the parents bonded with the place and experienced rootedness and familiarity. The hospice became a place of living and belonging; a place where they could ‘come home’.     

The VA vascular injury study: A glimpse at quality of care in Veterans with traumatic vascular injury repair

ObjectiveThe high number of limb injuries among Post-9/11 Veterans and their long-term care pose significant challenges to clinicians. Current follow-up for extremity arterial vascular injury (EVI) is based on guideline-concordant care for treatment of peripheral vascular disease (GCC-PVD), including anticoagulant/antiplatelet or statin therapy and duplex ultrasound. No best practices exist for arterial EVI. Our goal was to determine correlates of GCC-PVD and other care among Post-9/11 Veterans with combat-related arterial EVI.Materials and methodsWe identified Post-9/11 Veterans with arterial EVI who underwent initial limb salvage repair or ligation (e.g., for single-vessel injury) attempt per DoD Trauma Registry validated by chart abstraction. Veterans Health Administration (VHA) data characterized the cohort in the first five years of VHA care. Models predicted (a) GCC-PVD, (b) pain clinic use, (c) mental/behavioral health care, (d) long-term opioid use, and (e) time to complication, controlling for injury severity and type, mental health parameters, and demographics.ResultsThe 490-Veteran cohort with validated arterial injury was 77% White averaging 25.2 years at injury (range: 18–56). Mechanism of injury was primarily explosive (63%). Veterans had Injury Severity Scores classified as mild (60%), moderate (25%) and severe (15%). Approximately 25% received at least one component of VHA GCC-PVD including 8% arterial ultrasounds, 5% statins, and 11% anticoagulants/antiplatelets; 77% had mental/behavioral healthcare. GCC-PVD, as well as PTSD and substance use disorders, were associated with receipt of mental/behavioral health care. Complications affected 46% of the cohort and were more common among those prescribed 90+ days of opioids or receiving GCC-PVD.ConclusionDespite injury severity (40% moderate/severe), only 25% of cohort patients received VHA GCC-PVD, and nearly half had complications from their arterial injury. Receiving GCC-PVD appeared to potentiate receiving care for mental and behavioral disorders.ImpactThe treatment gap in Veterans with arterial EVI may be due to lack of appropriate guidelines, lack of vascular specialists in VHA or accessing care outside the VHA. Focused study of care options and their outcomes will help define optimal care processes for combat Veterans with arterial EVI.