Abolitionist Reimaginings of Health.

In 2020, the authors of this article published "Abolition Medicine" as one contribution to international abolitionist conversations responding to widespread anti-Black police violence and inequity laid bare by the COVID-19 pandemic. Over the past year, there has been a surge of efforts to abolish deeply embedded patterns of race-based oppression in policing and incarceration in the United States. In this essay, the authors continue to explore how health care can join these conversations and move toward a praxis of health justice. Using the framework of Ruth Wilson Gilmore's organized abandonment, the article revisits grassroots organizations and efforts that have been engaging in abolitionist health care all along. It also looks to current and emerging abolitionist policies and practices operating at the margins of status quo health care for models of abolition in medicine.

Military metaphors and pandemic propaganda: unmasking the betrayal of 'Healthcare Heroes'.

Dr Caitríona L Cox's recent article expounds the far-reaching implications of the 'Healthcare Hero' metaphor. She presents a detailed overview of heroism in the context of clinical care, revealing that healthcare workers, when portrayed as heroes, face challenges in reconciling unreasonable expectations of personal sacrifice without reciprocity or ample structural support from institutions and the general public. We use narrative medicine, a field primarily concerned with honouring the intersubjective narratives shared between patients and providers, in our attempt to deepen the discussion about the ways Healthcare Heroes engenders military metaphor, antiscience discourse, and xenophobia in the USA. We argue that the militarised metaphor of Healthcare Heroes not only robs doctors and nurses of the ability to voice concerns for themselves and their patients, but effectively sacrifices them in a utilitarian bargain whereby human life is considered the expendable sacrifice necessary to 'open the U.S. economy'. Militaristic metaphors in medicine can be dangerous to both doctors and patients, thus, teaching and advocating for the critical skills to analyse and alter this language prevents undue harm to providers and patients, as well as our national and global communities.

Queer Frontiers in Medicine: A Structural Competency Approach.

In 2014, the Association of American Medical Colleges (AAMC) published a report proposing qualifiers of competence to guide medical educators towards training physicians to appropriately care for individuals who are or may be lesbian, gay, bisexual, transgender (LGBT); gender nonconforming (GNC); and/or born with differences in sex development (DSD). These qualifiers provide content and context to an existing framework heavily used in competency-based medical education, emphasizing individual and interpersonal abilities to enhance care delivered to individuals identifying as LGBT, GNC, and/or born with DSD. However, systemic and societal forces including health insurance, implicit bias, and legal protections significantly impact the health of these communities. The concept of structural competency proposes that it is necessary to consider these larger forces contributing to and sustaining disease and health in order to fully address identity-based health needs. Competing competency frameworks for addressing diversity may be counterproductive to the ultimate goal of improving health outcomes among diverse communities. In this article, frameworks are reconciled by proposing structural competency as one approach for teaching identity-based health-related competencies that can be feasibly implemented for medical educators seeking to comply with the AAMC's recommendations. This article aims to "queer"-or to open up-possibilities in medical education in an effort to ultimately support the provision of equitable and responsible health care to people who are LGBT, GNC, and/or born with DSD through the use of innovative frameworks and teaching materials.

Visionary medicine: speculative fiction, racial justice and Octavia Butler's 'Bloodchild'.

Medical students across the USA have increasingly made the medical institution a place for speculating racially just futures. From die-ins in Fall 2014 to silent protests in response to racially motivated police brutality, medical schools have responded to the public health crisis that is racial injustice in the USA. Reading science fiction may benefit healthcare practitioners who are already invested in imagining a more just, healthier futurity. Fiction that rewrites the future in ways that undermine contemporary power regimes has been termed 'visionary fiction'. In this paper, the authors introduce 'visionary medicine' as a tool for teaching medical students to imagine and produce futures that preserve health and racial justice for all. This essay establishes the connections between racial justice, medicine and speculative fiction by examining medicine's racially unjust past practices, and the intersections of racial justice and traditional science and speculative fiction. It then examines speculative fiction author Octavia Butler's short story 'Bloodchild' as a text that can introduce students of the medical humanities to a liberatory imagining of health and embodiment, one that does not reify and reinscribe boundaries of difference, but reimagines the nature of Self and Other, power and collaboration, agency and justice.

The Space That Difference Makes: On Marginality, Social Justice and the Future of the Health Humanities.

Feminist theorist and educator, bell hooks, asserts that to seek true liberation one must choose marginality. One must choose to occupy the space outside the binary between colonizer-colonized, hegemonic center-periphery, and us-them in order to create a location of possibility. This essay will reveal the practice of social justice as the navigation of the space that difference makes and argue that choosing marginality provides a framework for health humanities work towards social justice in health care. The space of the launderette that is depicted in Hanif Kureishi's 1986 film, My Beautiful Laundrette, provides an example of choosing marginality and illustrates how difference structures both real and imagined spaces, which influences how individuals ultimately perceive one another. We will draw from the work of bell hooks; political geographer, Edward Soja; and Marxist philosopher, Henri Lefebvre, to demonstrate the importance of the health humanities' position at the margin to traditional health care education.

Bringing home the health humanities: narrative humility, structural competency, and engaged pedagogy.

As health humanities programs grow and thrive across the country, encouraging medical students to read, write, and become more reflective about their professional roles, educators must bring a sense of self-reflexivity to the discipline itself. In the health humanities, novels, patient histories, and pieces of reflective writing are often treated as architectural spaces or "homes" that one can enter and examine. Yet, narrative-based learning in health care settings does not always allow its participants to feel "at home"; when not taught with a critical attention to power and pedagogy, the health humanities can be unsettling and even dangerous. Educators can mitigate these risks by considering not only what they teach but also how they teach it.In this essay, the authors present three pedagogical pillars that educators can use to invite learners to engage more fully, develop critical awareness of medical narratives, and feel "at home" in the health humanities. These pedagogical pillars are narrative humility (an awareness of one's prejudices, expectations, and frames of listening), structural competency (attention to sources of power and privilege), and engaged pedagogy (the protection of students' security and well-being). Incorporating these concepts into pedagogical practices can create safe and productive classroom spaces for all, including those most vulnerable and at risk of being "unhomed" by conventional hierarchies and oppressive social structures. This model then can be translated through a parallel process from classroom to clinic, such that empowered, engaged, and cared-for learners become empowering, engaging, and caring clinicians.

Dietary effect of capric acid containing soyphospholipids.

A comparative evaluation of the dietary effect between capric acid (C10:0)-containing soyphospholipids and soyphospholipids without capric acid on the lipid profile of serum of rats when ingested at 5% or 10% level by weight in soybean oil was made. Rats were taken in five groups. One group was fed 20% soybean oil. Two groups received soybean oil containing 5% and 10% soyphospholipids by weight, respectively. Other two groups were fed soybean oil containing 5% and 10% capric acid containing soyphospholipids by weight, respectively. The other dietary components remained same for all the groups. The feeding was done for 4 weeks. At the end of feeding period there was no althrough significant change in weight gain, food intake and food efficiency ratio (FER). No significant change was observed in serum lipid profiles between the rats fed soybean oil and soybean oil with 5% or 10% soyphospholipids. There was significant decrease in serum total cholesterol (TC) and high density lipoprotein (HDL)-cholesterol level in the rats fed soybean oil blended with capric acid containing soyphospholipids at 5% level. The level of TC, triglyceride (TG), very low density lipoprotein (VLDL)-cholesterol decreased significantly when the rats were fed capric acid containing soyphospholipids at 10% level. There is overall significant change in TC, TG, VLDL- and LDL-cholesterol. The possible mechanism behind the reduction of serum lipid profile may be the reduction of interfacial tension of phospholipids could affect serum lipid profiles due to enhanced or much greater extent of emulsification of the both polar and nonpolar lipid components and their transfer from the intestine to the bile pathway.

Dietary effect of eicosapentaenoic acid (EPA) containing soyphospholipid.

In this study, we evaluated on a comparative basis the dietary effect between eicosapentaenoic acid (C20:5, EPA)- containing soyphospholipid and soyphospholipid without EPA when added at 5% or 10% level by weight in soybean oil as the dietary oil on the proportions of lipid components in serum of rats. Rats were taken in five groups. One group was fed 20% soybean oil. Two groups received soybean oil containing 5% and 10% soyphospholipid by weight, respectively. Two other groups were fed soybean oil containing 5% and 10% EPA- containing soyphospholipid by weight, respectively. The other dietary components remained same for all the groups. The feeding experiment was conducted for 4 weeks. After the feeding period there was no significant change in weight gain, food intake and food efficiency ratio (FER). No significant change was observed in serum lipid profiles between the rats fed soybean oil and soybean oil with 5% or 10% soyphospholipid. There was significant decrease in serum triglyceride (TG) level in the rats fed soybean oil blended with EPA containing soyphospholipid at 5% level. The contents of total cholesterol (TC), TG, very low density lipoprotein (VLDL)-cholesterol and low density lipoprotein (LDL)-cholesterol decreased significantly while high density lipoprotein (HDL)-cholesterol increased compared to the soyphospholipid group at 10% level.

Dietary effect of gamma-linolenic acid on the lipid profile of rat fed erucic acid rich oil.

This study evaluated the effects of dietary supplementation of gamma-Linolenic acid (18:3n-6, GLA) on the lipid profile of serum and other tissues of rats fed erucic acid (C22:1) rich oil like mustard oil. The rats were fed diet containing 20% mustard oil as erucic acid rich oil and 20% groundnut oil as dietary fat. These groups were kept as reference groups. Another group fed diet containing 20% fat to which evening primrose oil as a source of GLA was blended with mustard oil and groundnut oil at 5% level. The feeding experiment was done for 4 weeks. In another set mustard oil fed group was kept as control while the experimental group was fed evening primrose oil as a source of GLA blended with mustard oil at 2.5% level. The feeding experiment was carried out for 12 weeks. The other dietary components remained same for all the groups. After the scheduled feeding period, it was found that there was no significant change in weight gain, food intake and food efficiency ratio. It was found that dietary GLA resulted in significant decrease in serum triglyceride (TG) and very low density lipoprotein (VLDL) cholesterol and significant increase in high density lipoprotein (HDL) cholesterol in serum in the experimental group. In liver total cholesterol (TC) is significantly higher and in heart and liver TG is significantly lower in GLA fed group.

Between stillness and story: lessons of children's illness narratives.

In answer to an increasingly impersonal medical environment, educators in the medical humanities frequently turn to narrative studies to teach students for an emotionally fulfilling and interpersonally related professional practice. However, to elicit, to interpret, and to integrate patient stories into their work effectively, physicians must be in a state of awareness and attention, attuned to their emotional and intellectual reactions. The experiences of children and their families, in the form of pediatric illness narratives, hold unique insights for physicians in how to engage in an ethical, empathetic, and self-reflective practice. In particular, these narratives demonstrate the importance not only of story but also of stillness or silence to the practice of medicine. The voices of patients and their families hold both literal and allegorical lessons for physicians in how to move toward a medical practice involving not only diagnosis and treatment but also recognition and healing.

Medical education for social justice: Paulo Freire revisited.

Although social justice is an integral component of medical professionalism, there is little discussion in medical education about how to teach it to future physicians. Using adult learning theory and the work of Brazilian educator Paulo Freire, medical educators can teach a socially-conscious professionalism through educational content and teaching strategies. Such teaching can model non-hierarchical relationships to learners, which can translate to their clinical interactions with patients. Freirian teaching can additionally foster professionalism in both teachers and learners by ensuring that they are involved citizens in their local, national and international communities.