Self-inflicted. Deliberate. Death-intentioned. A critical policy analysis of UK suicide prevention policies 2009-2019

Purpose With encouragement from the World Health Organisation, national suicide prevention policies have come to be regarded as an essential component of the global effort to reduce suicide. However, despite their global significance, the construction, conceptualisation and proposed provisions offered in suicide prevention policies have, to date, been under researched; this study aims to address this gap. Design/methodology/approach we critically analysed eight contemporary UK suicide prevention policy documents in use in all four nations of the UK between 2009 and 2019, using Bacchi and Goodwin’s post-structural critical policy analysis. Findings The authors argue that across this sample of suicide prevention policies, suicide is constructed as self-inflicted, deliberate and death-intentioned. Consequently, these supposedly neutral definitions of suicide have some significant and problematic effects, often individualising, pathologising and depoliticising suicide in ways that dislocate suicides from the emotional worlds in which they occur. Accordingly, although suicide prevention policies have the potential to think beyond the boundaries of clinical practice, and consider suicide prevention more holistically, the policies in this sample take a relatively narrow focus, often reducing suicide to a single momentary act and centring death prevention at the expense of considering ways to make individual lives more liveable. Originality/value UK suicide prevention policies have not been subject to critical analysis; to the best of the authors’ knowledge, this study represents the first attempt to examine the way in which suicide is constructed in UK suicide prevention policy documents.

Phage therapy of wound-associated infections

Phages are viruses which can specifically infect bacteria, resulting in their destruction. Bacterial infections are a common complication of wound healing, and experimental evidence from animal models demonstrates promising potential for phage-dependent eradication of wound-associated infections. The studies discussed suggest that phage therapy may be an effective treatment, with important advantages over some current antibacterial treatments. Phage cocktails, as well as co-administration of phages and antibiotics, have been reported to minimise bacterial resistance. Further, phage-antibiotic synergism has been reported in some studies. The ideal dose of phages is still subject to debate, with evidence for both high and low doses to yield therapeutic effects. Novel delivery methods, such as hydrogels, are being explored for their advantages in topical wound healing. There are more and more Good Manufacturing Practice facilities dedicated to manufacturing phage products and phage therapy units across the world, showing the changing perception of phages which is occurring. However, further research is needed to secure the place of phages in modern medicine, with some scientists calling upon the World Health Organisation to help promote phage therapy.

Molecular Epidemiology of Salmonella enterica in Poultry in South Africa Using the Farm-to-Fork Approach

The presence of the zoonotic pathogen Salmonella in the food supply chain poses a serious public health threat. This study describes the prevalence, susceptibility profiles, virulence patterns, and clonality of Salmonella from a poultry flock monitored over six weeks, using the farm-to-fork approach. Salmonella was isolated using selective media and confirmed to the genus and species level by real-time polymerase chain reaction (RT-PCR) of the invA and iroB genes, respectively. Antimicrobial susceptibility profiles were determined using Vitek-2 and the Kirby–Bauer disk diffusion method against a panel of 21 antibiotics recommended by the World Health Organisation Advisory Group on Integrated Surveillance of Antimicrobial Resistance (WHO-AGISAR). Selected virulence genes were identified by conventional PCR, and clonality was determined using enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Salmonella was present in 32.1% of the samples: on the farm (30.9%), at the abattoir (0.6%), and during house decontamination (0.6%). A total of 210 isolates contained the invA and iroB genes. Litter, faeces, and carcass rinsate isolates were classified as resistant to cefuroxime (45.2%), cefoxitin (1.9%), chloramphenicol (1.9%), nitrofurantoin (0.4%), pefloxacin (11.4%), and azithromycin (11%). Multidrug resistance (MDR) was observed among 3.8% of the isolates. All wastewater and 72.4% of carcass rinsate isolates were fully susceptible. All isolates harboured the misL, orfL, pipD, stn, spiC, hilA, and sopB virulence genes, while pefA, spvA, spvB, and spvC were absent. In addition, fliC was only present among the wastewater isolates. Various ERIC-PCR patterns were observed throughout the continuum with different subtypes, indicating the unrelated spread of Salmonella. This study concluded that poultry and the poultry environment serve as reservoirs for resistant and pathogenic Salmonella. However, there was no evidence of transmission along the farm-to-fork continuum.

Alt. Health Influencers: how wellness culture and web culture have been weaponised to promote conspiracy theories and far-right extremism during the COVID-19 pandemic

This article examines the proliferation of alt. health influencers during the COVID-19 pandemic. I analyse the self-presentation strategies used by four alt. health influencers to achieve visibility and status on Instagram over a 12-month period from 11 March 2020, when the pandemic was declared by the World Health Organisation. My analysis reveals the ways in which these influencers appeal to the utopian discourses of early web culture and the underlying principles of wellness culture to build and sustain an online following. While early accounts of micro-celebrity treat participatory culture as democratising and progressive, this article demonstrates how the participatory affordances of social media have been exploited to spread misinformation, conspiratorial thinking and far-right extremism. These findings develop previous work on ‘conspirituality’ by demonstrating how wellness culture and web culture can coalesce for authoritarian ends.

Reducing the Risk of Cognitive Decline and Dementia: WHO Recommendations

With population ageing worldwide, dementia poses one of the greatest global challenges for health and social care in the 21st century. In 2019, around 55 million people were affected by dementia, with the majority living in low- and middle-income countries. Dementia leads to increased costs for governments, communities, families and individuals. Dementia is overwhelming for the family and caregivers of the person with dementia, who are the cornerstone of care and support systems throughout the world. To assist countries in addressing the global burden of dementia, the World Health Organisation (WHO) developed the Global Action Plan on the Public Health Response to Dementia 2017–2025. It proposes actions to be taken by governments, civil society, and other global and regional partners across seven action areas, one of which is dementia risk reduction. This paper is based on WHO Guidelines on risk reduction of cognitive decline and dementia and presents recommendations on evidence-based, multisectoral interventions for reducing dementia risks, considerations for their implementation and policy actions. These global evidence-informed recommendations were developed by WHO, following a rigorous guideline development methodology and involved a panel of academicians and clinicians with multidisciplinary expertise and representing geographical diversity. The recommendations are considered under three broad headings: lifestyle and behaviour interventions, interventions for physical health conditions and specific interventions. By supporting health and social care professionals, particularly by improving their capacity to provide gender and culturally appropriate interventions to the general population, the risk of developing dementia can be potentially reduced, or its progression delayed.

Lymphoma for GPs across the cancer continuum

Lymphomas are a diverse and relatively common cancer type in the UK. Early diagnosis of lymphoma is vital for improving patient outcomes. The majority of patients diagnosed with lymphoma have a life expectancy of more than 5 years. Lymphoma treatments can have long-term health consequences, and patients with a history of lymphoma have a higher risk of subsequently developing other cancers. More robust evidence for the early diagnosis of lymphoma in primary care has been published in recent years, and the classification of lymphoma has recently been updated by the World Health Organisation. This article focuses on the diagnosis of lymphoma in adolescents and adults and the on-going care needs of patients who are being treated for lymphoma or have survived a diagnosis of lymphoma. Further information about lymphoma and other cancers in children can be found in the InnovAiT article by Dr Jennifer Kelly published in 2017.

Access to Medicines and Medical Equipment during COVID-19: Searching Compatibility between the WTO and the WHO

Affordable access to medicines is a key determinant of a country’s resilience to health crises. The modern hyper-connected international trade and production networks have a vital role to play in ensuring this accessibility, especially in the context of a pandemic. This article focuses on the medicines and medical equipment and analyses the synergistic role of the two international organisations—The World Trade Organisation (WTO) and The World Health Organisation (WHO), in assuring affordable access to these goods globally. WHO is responsible for global healthcare regulations; however, the medical supply chain originates in a few developed countries, manufactured in bulk (in case of medicine) at low cost in developing countries, and finally traded worldwide. Here, the role of WTO comes—it facilitates global trade cooperation and intellectual property rights monitoring, both key elements in medical goods production and trading. Despite the need for cooperation in mitigating COVID-19, much of the global response to COVID-19 has been fragmented and inward-looking. This lack of coordination has serious repercussions especially for developing countries. We use qualitative content analysis methodology, connecting concepts of cooperation theory and global governance, to identify the joint role of the two organisations in fostering global cooperation in medical goods accessibility.

Network analysis regarding international organisations and donors of humanitarian aid

This study aims to evaluate the status of the partnerships with important international organisations that Korea employs in operating its foreign aid projects from a humanitarian point of view. On the basis of this information, Korea intends to seek ways of effectively supporting underdeveloped countries through future co-operation with these organisations. The main international organisations analysed are the World Food Programme (WFP), the United Nations Children’s Fund (UNICEF), the United Nations High Commissioner for Refugees (UNHCR), the World Health Organisation (WHO), the United Nations Development Program (UNDP), the (United Nations) Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), the Food and Agriculture Organisation (FAO), the International Committee of the Red Cross (ICRC) and the Office for the Coordination of Humanitarian Affairs (OCHA). These international organisations support underdeveloped countries through co-operative relationships not only with Korea but also with important donor countries of the OECD. This study focuses on establishing the factors that Korea needs to consider when providing humanitarian aid in the future to underdeveloped countries via such international organisations.

Dementia Risk Scores and Their Role in the Implementation of Risk Reduction Guidelines

Dementia prevention is a global health priority. In 2019, the World Health Organisation published its first evidence-based guidelines on dementia risk reduction. We are now at the stage where we need effective tools and resources to assess dementia risk and implement these guidelines into policy and practice. In this paper we review dementia risk scores as a means to facilitate this process. Specifically, we (a) discuss the rationale for dementia risk assessment, (b) outline some conceptual and methodological issues to consider when reviewing risk scores, (c) evaluate some dementia risk scores that are currently in use, and (d) provide some comments about future directions. A dementia risk score is a weighted composite of risk factors that reflects the likelihood of an individual developing dementia. In general, dementia risks scores have a wide range of implementations and benefits including providing early identification of individuals at high risk, improving risk perception for patients and physicians, and helping health professionals recommend targeted interventions to improve lifestyle habits to decrease dementia risk. A number of risk scores for dementia have been published, and some are widely used in research and clinical trials e.g., CAIDE, ANU-ADRI, and LIBRA. However, there are some methodological concerns and limitations associated with the use of these risk scores and more research is needed to increase their effectiveness and applicability. Overall, we conclude that, while further refinement of risk scores is underway, there is adequate evidence to use these assessments to implement guidelines on dementia risk reduction.