Fiona Webster

The value of diagnosing the pathologically bereaved, as affected by a distinct disorder from depression, anxiety, or post-traumatic stress disorder, has long been debated by clinicians and scholars alike. Disputes continue over whether a specific diagnosis would help those struggling after loss, even after prolonged grief disorder gained official status in 2022 as a condition recognized and defined in the Diagnostic and Statistical Manual of Mental Disorders. This paper examines how different medical conceptualizations of grief have helped shape the development and use of pharmaceutical interventions to treat the bereaved over the past century. Using a Foucauldian-inspired approach and a biopolitics framework, this paper traces the multifaceted history of grief as a condition that can be targeted and treated through medication and medical interventions.

Purpose: Ideal family building years inevitably coincide with training and early career for surgeons. Quantitative studies have demonstrated that maternity leave for surgeon mothers can be a significant source of stress and indecision, leading to significantly shorter maternity leaves than both non-surgeon physicians and the general population. This study sought to qualitatively explore the experience of navigating maternity leave as a surgeon mother. Methods: Surgeons and surgical trainees participated in semi-structured interviews that explored their experience of motherhood. Interviews were transcribed and de-identified. Constructivist grounded theory was for analysis. Open coding was conducted by the entire research team to establish familiarity with the data, followed by refined coding by two authors. Themes were discussed with the entire research team until the key themes were finalized. Results: Sixteen surgeons across surgical specialties participated, including three residents and one fellow. An equal number had their first child in residency compared to in early career. Three major themes emerged from the data regarding maternity leave: (1) Productivity, (2) Pressure and (3) Policies. Productivity encapsulated the incredible amount of work that surgeon mothers continued to complete throughout their maternity leaves. This included completing advanced degrees, exam preparation, academic and research work. Pressure was evident both through external sources demanding productivity and early return to work as well as internal pressures and guilt to prove oneself as not lesser than colleagues once embodying the roles of both mother and surgeon. Policies were not in place to protect surgeon mothers during their maternity leaves, and this included policies to protect surgeons financially or temporally. Conclusion: Surgeon mothers face unique challenges to navigating maternity leave due to current organizational and cultural norms. Addressing policies to support surgeon maternity leave is an important step, but policies alone will fail without cultural shifts and surgical leadership that truly support surgeons in their pursuit of motherhood.

There has been a recent and, for many within the chronic pain space, long-overdue increase in literature that focuses on equity, diversity, inclusion, and decolonization (EDI-D) to understand chronic pain among people who are historically and structurally marginalized. In light of this growing attention in chronic pain research, we undertook a scoping review of studies that focus on people living with chronic pain and marginalization to map how these studies were carried out, how marginalization was conceptualized and operationalized by researchers, and identify suggestions for moving forward with marginalization and EDI-D in mind to better support people living with chronic pain. We conducted this scoping review using critical analysis in a manner that aligns with dominant scoping review frameworks and recent developments made to scoping review methodology as well as reporting guidelines. Drawing on 67 studies, we begin with a descriptive review of the literature followed by a critical review that aims to identify fissures within the field through the following themes: (1) varying considerations of sociopolitical and socioeconomic contexts, (2) conceptual conflations between sex and gender, and (3) differing approaches to how people living with chronic pain and marginalization are described. By identifying strengths and limitations in the research literature, we aim to highlight opportunities for researchers to contribute to a more comprehensive understanding of marginalization in chronic pain experiences.

Objectives To understand the factors influencing young athletes’ perceptions of quality of life (QOL) following an anterior cruciate ligament (ACL) rupture, prior to reconstructive surgery. Design Qualitative descriptive study using semi-structured interviews and thematic analysis of data. Setting Tertiary sports medicine clinic with patients recruited from the practices of three specialist orthopaedic surgeons. Participants Twenty athletes aged 14–25 provided consent to participate in the study and completed interviews prior to their ACL reconstruction surgery. Participants were eligible to participate if they were scheduled to undergo ACL reconstruction, were 25 years of age or younger, identified as athletes (participated in any level of organised sport), could communicate in English and agreed to be audio recorded. Participants were not eligible if they had experienced a multiligament injury or fracture. Results Young athletes shared common factors that made up their QOL; social connections and support, sport, health, and independence. However, participants’ perceptions of their current QOL were quite variable (13–95/100 on a Visual Analogue Scale). Participants who were able to reframe their injury experience by shifting focus to the positive or unaffected aspects of their lives tended to have more favourable perceptions of their QOL than participants who shifted focus to the losses associated with injury. Conclusions Young athletes who have experienced an ACL injury define their QOL based on social support, sport, health and independence. Individual processes of adaptation and cognitive reframing in response to an ACL injury may exert a greater influence on postinjury QOL than the physical ramifications of the injury itself. Understanding individual perceptions may help target potential interventions or supports to enhance athletes’ adaptation to injury.