Planetary Health: Capitalism, Ecology and Eco-Socialism

Adopting a critical anthropology of health perspective, informed by political ecology, we examine planetary health in the era of late capitalism or neoliberalism. The shift to a planetary health thinking was driven by the growing awareness that not only are all human communities now multiply linked together by flows of commodities, ideas, people, and health-related influences from vectors to medicines, but that the health of human communities is multiply linked to the environment including other species within us (e.g. gut flora) and around us. Within the planetary health framework, we focus specifically on both emerging and re-emerging infectious diseases, particularly the COVID-19 pandemic, and the growing impact of anthropogenic climate change on health. While poorer regions of the world need economic development, that is, access to basic resources and health care, much of the developed world and parts of the developing world are, in a sense, overdeveloped. Perhaps more than any other issue, the ecological crisis, which includes catastrophic climate change allows critical scholars to contemplate the contradictions of the capitalist world system, including its implications for health, and to ponder the creation of an alternative world system, namely eco-socialism. © 2023 The Center for Political Ecology.

A Companion to Medical Anthropology

The fully revised new edition of the defining reference work in the field of medical anthropology A Companion to Medical Anthropology, Second Edition provides the most complete account of the key issues and debates in this dynamic, rapidly growing field. Bringing together contributions by leading international authorities in medical anthropology, this comprehensive reference work presents critical assessments and interpretations of a wide range of topical themes, including global and environmental health, political violence and war, poverty, malnutrition, substance abuse, reproductive health, and infectious diseases. Throughout the text, readers explore the global, historical, and political factors that continue to influence how health and illness are experienced and understood. The second edition is fully updated to reflect current controversies and significant new developments in the anthropology of health and related fields. More than twenty new and revised articles address research areas including war and health, illicit drug abuse, climate change and health, colonialism and modern biomedicine, activist-led research, syndemics, ethnomedicines, biocommunicability, COVID-19, and many others. Highlighting the impact medical anthropologists have on global health care policy and practice, A Companion to Medical Anthropology, Second Edition: Features specially commissioned articles by medical anthropologists working in communities worldwide Discusses future trends and emerging research areas in the field Describes biocultural approaches to health and illness and research design and methods in applied medical anthropology Addresses topics including chronic diseases, rising levels of inequality, war and health, migration and health, nutritional health, self-medication, and end of life care Part of the acclaimed Wiley Blackwell Companions to Anthropology series, A Companion to Medical Anthropology, Second Edition, remains an indispensable resource for medical anthropologists, as well as an excellent textbook for courses in medical anthropology, ethnomedicine, global health care, and medical policy. © 2022 John Wiley and Sons Ltd.

At the Heart of Learning: Affect, Identity and Care

Over the last few years, learning scientists have become increasingly interested in research around student's motivational and emotional processes, guided by a commitment to affirm learners' individual identities and support justice-oriented design and pedagogies. With ample evidence to show that the Covid-19 pandemic has exaggerated learner's struggles with their thoughts, feelings, and identity, the importance of such research has never been higher. This symposium brings together an international group of scholars with varying research contexts (online, in-person, hybrid, blended), working with students of different age groups (K-12, Undergraduates, pre-service teachers) to present their work around affective learning and teaching. The symposium's focus on affective learning designs that acknowledge learner emotions, affirm their identity, foster designer empathy and build a pedagogy of care will springboard deeper discussions in the ISLS community to further explore "global perspectives on equity and justice that promote the empowerment of educational innovation for all” (ISLS, 2022). © ISLS.

Reducing broad-spectrum antibiotic use in intensive care unit between first and second waves of COVID-19 did not adversely affect mortality.

BACKGROUND: The COVID-19 pandemic increased the use of broad-spectrum antibiotics due to diagnostic uncertainty, particularly in critical care. Multi-professional communication became more difficult, weakening stewardship activities. AIM: To determine changes in bacterial co-/secondary infections and antibiotics used in COVID-19 patients in critical care, and mortality rates, between the first and second waves. METHODS: Prospective audit comparing bacterial co-/secondary infections and their treatment during the first two waves of the pandemic in a single-centre teaching hospital intensive care unit. Data on demographics, daily antibiotic use, clinical outcomes, and culture results in patients diagnosed with COVID-19 infection were collected over 11 months. FINDINGS: From March 9th, 2020 to September 2nd, 2020 (Wave 1), there were 156 patients and between September 3rd, 2020 and February 1st, 2021 (Wave 2) there were 235 patients with COVID-19 infection admitted to intensive care. No significant difference was seen in mortality or positive blood culture rates between the two waves. The proportion of patients receiving antimicrobial therapy (93.0% vs 81.7%; P < 0.01) and the duration of meropenem use (median (interquartile range): 5 (2-7) vs 3 (2-5) days; P = 0.01) was lower in Wave 2. However, the number of patients with respiratory isolates of Pseudomonas aeruginosa (4/156 vs 21/235; P < 0.01) and bacteraemia from a respiratory source (3/156 vs 20/235; P < 0.01) increased in Wave 2, associated with an outbreak of infection. There was no significant difference between waves with respect to isolation of other pathogens. CONCLUSION: Reduced broad-spectrum antimicrobial use in the second wave of COVID-19 compared with the first wave was not associated with significant change in mortality.

Comparison of Antibiotic Use between the First Two Waves of COVID-19 in an Intensive Care Unit at a London Tertiary Centre: reducing broad-spectrum antimicrobial use did not adversely affect mortality

Background The COVID-19 pandemic increased the use of broad-spectrum antibiotics due to diagnostic uncertainty, particularly in critical care. Multiprofessional communication became more difficult, weakening stewardship activities. Aim To determine changes in bacterial co-/secondary infections and antibiotics used in COVID-19 patients in critical care, and mortality rates, between the first and second waves. Methods Prospective audit comparing bacterial co-/secondary infections and their treatment during the first two waves of the pandemic in a single centre teaching hospital ICU. Data on demographics, daily antibiotic use, clinical outcomes, and culture results in patients diagnosed with COVID-19 infection were collected over 11 months. Findings From 9/3/20 to 2/9/20 (Wave 1), there were 156 patients and between 3/9/20 and 1/2/21 (Wave 2) there were 235 patients with COVID-19 infection admitted to intensive care. No significant difference was seen in mortality or positive blood culture rates between the two waves. The proportion of patients receiving antimicrobial therapy (93.0% vs 81.7%;p<0.01), and the duration of meropenem use (median (interquartile range): 5 (2-7) vs 3 (2-5) days;p=0.01) was lower in Wave 2. However, the number of patients with respiratory isolates of Pseudomonas aeruginosa (4/156 vs 21/235;p<0.01) and bacteraemia from a respiratory source (3/156 vs 20/235 p<0.01) increased in Wave 2, associated with an outbreak of infection. There was no significant difference between waves with respect to isolation of other pathogens. Conclusions Reduced broad spectrum antimicrobial use in the second wave of COVID-19 compared with the first wave was not associated with significant change in mortality.

Serum RPR negative case of neurosyphilis in an AIDS patient with bilateral lrecurrent artery of Heubner infarcts

Objective: To report a case of a 47-year-old male with AIDS found to have multifocal strokes including bilateral recurrent artery of Heubner infarcts due to meningovascular neurosyphilis despite a negative serum RPR. Background: Meningovascular neurosyphilis occurs in 3% of all patients with syphilis and manifests as a meningoencephalitic syndrome with cerebrovascular events. The majority of patients affected by meningovascular neurosyphilis are under 50-years-old, and as such it is standard clinical practice to use serum RPR as a screening test for stroke in the young. However, serum RPR can be false-negative in certain cases. Design/Methods: NA Results: A 47-year-old Caucasian male with a past medical history of HIV and alcohol/drug use was found down in his home with last known normal ten days prior. On admission, BP was 178/105, HR 135, and NIHSS 12 for confusion and right hemiplegia. NCCT Head showed bilateral basal ganglia hypodensities, initially interpreted by radiology as hypoxic ischemic injury. MRI brain revealed infarcts of varying ages involving bilateral caudate heads, genu of corpus callosum, anterior commissure, left medial medulla with scattered leptomeningeal enhancement along the inferior frontal lobe and basal cistern. MRA showed moderate P2 narrowing adjacent to leptomeningeal enhancement. Serum studies were notable for a CD4 count of 88, nonreactive RPR, negative COVID-19, and unremarkable basic stroke work-up including TTE with bubble and telemetry. Alternate serum treponemal tests were not sent prior to LP. CSF showed lymphocytic pleocytosis (165 with 99% lymphs) with elevated protein of 78, reactive VDRL and FTAA with a VDRL titer 1:4. He was treated with IV penicillin and aspirin 81mg daily. Conclusions: Serum RPR may be an inadequate screening tool for stroke in the young, especially in the setting of AIDS. If clinical suspicion is high for meningovascular neurosyphilis, then further diagnostic work-up should be pursued with alternate serum treponemal studies and/or CSF studies.

Influence of respiratory and inflammatory parameters preceding intubation on survival of patients with COVID-19 ARDS- A single centre retrospective analysis.

It remains unclear if intubation and ventilation earlier in the disease course confers a survival advantage in acute respiratory distress syndrome. Our objective was to determine whether patients with COVID-19 who died following mechanical ventilation were more advanced in their disease compared to survivors. Forty-seven patients admitted directly to our centre received ventilation, of who 26 (57%) patients died. The rate of fall in SpO2:FiO2 ratio (p = 0.478) and increasing respiratory rate (p = 0.948) prior to IMV were similar between survivors and non-survivors. Our data support a trial of continuous positive airway pressure prior to IMV in patients with moderate-to-severe COVID-19 ARDS.

[Psychopharmacotherapy during the COVID-19 pandemic]. / Psychopharmakotherapie in Zeiten der COVID-19-Pandemie.

In view of the current coronavirus disease 2019 (COVID-19) pandemic, patient care, including that of psychiatric patients, is facing unprecedented challenges. Treatment strategies for mental illness include psychotherapy and psychopharmacological interventions. The latter are associated with a multitude of adverse drug reactions (ADR); however, they may currently represent the preferred treatment due to restrictions regarding patient care (i.e. social distancing). Direct contact to patients may have to be reduced in favor of telephone calls or video conferences, so that new techniques in diagnosing and treating patients have to be established to guarantee patient safety. Patients should be extensively informed about relevant ADRs and physicians should actively ask patients about the timely recognition of ADRs. The use of psychotropic drugs may lead to an increased risk of developing ADRs, which are considered to be particularly unfavorable if they occur simultaneously with an acute infection or may even lead to an increased risk of infection. These include respiratory depression, agranulocytosis, intoxication by inhibition of metabolizing enzymes and venous thromboembolism, each of which may be associated with potentially fatal consequences; however, physicians should simultaneously ensure adequate efficacy of treatment, since the ongoing crisis may lead to a worsening of preexisting mental illnesses and to a surge in first onset of psychiatric disorders.