The provision of pensions for Civil Servants and other employees in public office, such as the police, as well as in large private businesses, became more widespread in the second half of the nineteenth century. Such pensions, and other non-pay benefits, including sick pay, not only helped with recruitment but also provided a means of managing the retirement of workers who were deemed to be incapable of performing their roles. The rules governing eligibility to receive a pension in the Metropolitan Police in London were closely linked to the certification of poor health. Police doctors restricted the certification of sickness as a reason for retirement because it impacted the size of the force, resulted in the loss of more experienced men, and added to the cost of the pension fund. This strategy generated conflict with the workforce, resulting in industrial unrest. Piecemeal reforms failed to address workers’ concerns until 1890, when the rights to receive a pension were improved. These reforms, rather than stricter vigilance by police doctors, were an effective way of retaining experienced officers in the police force.

This article examines the effects of UK welfare reform since 2008 on people with mental health conditions and disabilities. The results have been profound, particularly during a time of economic austerity, damaging the social safety net and pushing many vulnerable people into poverty and hardship. It has perpetuated inequalities and increased the social exclusion of disabled groups. The holes in the safety net require repair, alongside extensive social policy reform to both protect and empower people with disabilities and long-term conditions.

La compétence culturelle telle qu’elle est développée au centre Françoise-Minkowska a ceci de particulier dans le fait qu’elle tient compte non seulement de la dynamique entre le thérapeute et le patient mais également du système de soins dans lequel fonctionne cette offre thérapeutique. Il s’agit essentiellement de mettre le thérapeute dans les conditions optimales pour élaborer un diagnostic ou une indication thérapeutique. La dimension linguistique bien entendu n’est jamais négligée, le travail se fait essentiellement sur la reconnaissance de la dynamique engagée par la confrontation des modèles explicatoires. Cela permet au patient d’exprimer sa souffrance avec ses propres termes et ses références culturelles (illness) et au thérapeute de formuler au plus juste la nosographie psychiatrique éventuelle (disease), tout en tenant compte des déterminants sociaux et de leur impact soit précarisant, soit déstructurant. Cette approche est celle de l’anthropologie médicale clinique.

La souffrance psychique des personnes migrantes et réfugiées est souvent le résultat de plusieurs facteurs. La dimension psychologique est évidemment en avant mais il ne faut plus ignorer l’impact des déterminants sociaux (sickness) sur les éventuels troubles de la personnalité. Il ne s’agit pas seulement de mettre en valeur la dimension sociale mais d’intégrer dans la prise en charge le rôle et l’importance des facteurs sociaux et sociétaux.

L’enseignement dans le cadre d’un diplôme universitaire à Paris-Descartes de l’anthropologie médicale clinique permet aux professionnels de la santé mentale et du social d’accéder à une approche théorique qui leur facilite le travail thérapeutique et l’accompagnement social. Les notions d’illness, sickness et disease autorisent un travail de décentrage et de confrontation de représentations culturelles de la souffrance psychique. Il est important que cette approche soit intégrée dans la formation des professionnels de la santé qui reçoivent des personnes migrantes et réfugiées.

Le centre Françoise-Minkowska reçoit des personnes migrantes et réfugiées de toute l’Île-de-France. L’originalité du dispositif mis en place pour la médiation, l’accueil et l’orientation (Mediacor) des patient(e)s a permis un éclairage particulier sur la place et le rôle des déterminants sociaux dans la trajectoire migratoire et le parcours d’exil. Cet impact des variables sociales et sociétales (sickness) est concomitant à l’expression de la souffrance psychique (illness). Les orientations vers le Centre faites par les travailleurs sociaux confirment l’importance de ces éléments.

In addition to their role as signaling molecules of the immune system, cytokines may participate in central neurotransmission. Variations of the central and/or peripheral levels of the proinflammatory cytokines, tumor necrosis factor-α (TNF-α) and interleukin-β (IL-1β), impact on neuroendocrine processes as well as central neurotransmitter activity. To a considerable extent, these effects are reminiscent of those elicited by psychogenic stressors. The current review describes recent findings consistent with a role for these cytokines in the neurochemical and behavioral manifestations of clinical depression, as well as the cellular death associated with cerebral ischemia. Moreover, the increasing use of cytokines in the immunotherapeutic treatment of various autoimmune diseases (e.g. rheumatoid arthritis) and cancers prompted us to consider the potential role of central processes in subserving the mood-related side-effects elicited by these treatments. Finally, a single administration of TNF-α has been shown to elicit a time-dependent sensitization effect, wherein the behavioral and neurochemical responses elicited by later cytokine treatment are greatly enhanced. Thus, particular attention was devoted to the possibility that elevated levels of TNF-α, through either exogenous (e.g. immunotherapy) or endogenous (e.g. brain damage or stressors) means may sensitize neurotransmitter or second messenger pathways important for the pathology. Given the time-dependent nature of cytokine sensitization effects, the schedule of cytokine administration during immunotherapy, or the timing of cytokine up-regulation in response to traumatic or stressful events may favor the development of sensitized central processes, which may influence clinical outcome.

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.

Background: Virtual environments in medical education are becoming increasingly popular as a learning tool. However, there is a large amount of evidence linking these systems to adverse effects that mimic motion sickness. It is also proposed that the efficacy of such systems is affected by how well they engage the user, which is often referred to as presence.

Purpose: This primary purpose of this study was to look at the side effects experienced and presence in the Virtual Environment for Radiotherapy Training (VERT) system which has recently been introduced.

Method: A pre-VERT questionnaire was given to 84 subjects to ascertain general health of the subjects. The simulator sickness questionnaire was utilised to determine the side effects experienced, whereas the igroup presence questionnaire was used to measure presence. Both questionnaires were given immediately after use of the VERT system.

Results: The majority of symptoms were minor; the two most commonly reported symptoms relating to ocular issues. No relationship was seen between simulator sickness and presence although subjects with a higher susceptibility to travel sickness had reported higher levels of disorientation and nausea. There was also a decrease in involvement with the system in subjects with a higher susceptibility to travel sickness.

Recent studies have begun to clarify the pathogenesis of sickness behavior. Cytokines released by macrophages, dendritic cells and mast cells act on the brain to trigger behavioral changes in infected animals. The major cytokines, interleukin-1, tumor necrosis factor alpha, and others, all act on the hypothalamus to provoke alterations in the normal homeostatic condition. These include elevated body temperature, increased sleep, and loss of appetite as well as major alterations in lipid and protein metabolism leading to significant weight loss. Some of these changes are clearly directed towards enhancing the normal immune responses. The benefits of others such as appetite loss are unclear. It is also important to recognize that other animals may recognize sickness behavior as a sign of weakness and mark the victim out for targeting by predators. As a result, some prey species may work very hard to mask their sickness, a response that serves to complicate veterinary diagnosis.

The paper considers a number of methods of estimating the work time lost due to sickness, unemployment and stoppages. The most satisfactory approach suggested is based on a multiple state working life table. Numerical examples of the measurement of work time lost are provided for particular application to the actuarial assessment of damages (arising out of personal injury or fatal accident). Other applications, including the pricing of unemployment insurance, are also discussed.