Health

"[T]here is no oxygen tank at the end of the rope, and if there had been... their lungs would have exploded... and their blood would have bubbled with nitrogen before they reached the surface. ...The human body can withstand the pressures of a fast three-hundred-foot... ascent only in its natural state. Some humans handle it better than others."

"I swam with these animals about 4 years ago. Some friends and I had heard that off the coast of Sri Lanka these huge congregations of s would gather in March and April."

"Inside of these clicks is encoded information... a secret language..."

"A group of scientists, acoustic engineers and free divers have... the goal of trying to crack the sperm whale communication code in the next 2 years. ...We're going to use and AI algorithms... We're already doing this with mice... bats..."

"No doctor has ever healed anyone of anything in the history of the world. The human immune system heals and that's the only thing that heals."

"Organic food"

"Immune system"

"Vegetarianism"

"A lot has been written about how this pandemic is exacerbating social inequalities. But what if it’s because our societies are so unequal that this pandemic happened? There is a that, historically, have been more likely to occur at times of social inequality and discord. As the poor get poorer, the thinking goes, their baseline health suffers, making them more prone to infection. At the same time they are forced to move more, in search of work, and to gravitate to cities. The rich, meanwhile, have more to spend on luxuries, including products that hail from far-flung places. The world becomes more tightly connected through trade, and germs, people and luxury goods travel together along trade routes that connect cities. On paper, it looks like a perfect storm."

"Yet for all the agonies and difficulties associated with arm loss, the bigger problem in low-income countries is when lower limb disability leads to loss of mobility. Wheelchairs are expensive and can be difficult to use when roads are pot-holed, streets are muddy and pavements are non-existent. Without a prosthetic limb, people struggle to fetch water, to prepare food and, above all, to work. This throws them back on their families and communities, intensifying any hardship and poverty."

"“If you wear a prosthesis you are disabled for about ten minutes in the morning while you have a shower, then you put your leg on and go to work. If you do not have one, then your hands are out of use with crutches so you can’t even take drinks to the table,” said Carson Harte, a 59-year-old prosthetist and chief executive of Exceed. “Without a prosthesis there are no expectations. You just go back and rely on the goodwill of your family.”"

"Stories of lives devastated by conflict or disease are all too common across low-income countries. Lack of an arm or leg can be tough anywhere, but for people in poorer parts of the planet, with so much less support and more rickety infrastructure, it is especially challenging. Some are victims of conflict, others were born with congenitall conditions. Many more are injured on roads, the casualty toll soaring in low-income nations even as it plummets in wealthier ones. Every minute, 20 people are seriously injured worldwide in road crashes. In Kenya, half the patients on surgical wards have road injuries. The World Health Organization (WHO) estimates there are about 30 million people like Nhial and Lam who require prosthetic limbs, braces, or other mobility devices. These can be simple to make and inexpensive. As one veteran prosthetist told me, his specialism is among the most instantly gratifying areas of medicine. “A patient comes in on Monday on crutches that leave them unable to carry anything. By Wednesday they are walking on a new leg and on Friday they leave with their life transformed.” Yet more than eight in 10 of those people needing mobility devices do not have them. They take a lot of work and expertise to produce and fit, and the WHO says there is a shortage of 40,000 trained prosthetists in poorer countries. There is also the time and cost to patients, who may have to travel long distances for treatment that can take five days—to assess need, produce a prosthesis and fit it to the residual limb. The result is that unglamorous items such as braces and artificial limbs are among the most-needed devices to assist lives. Yet, as in so many other areas, technology may be hurtling to the rescue, this time in the shape of 3-D printing."

"An effective prosthesis delivers renewed functionality and is cosmetically pleasing, but it also serves to complete the wearer’s sense of wholeness. A prosthesis then, is as much medical device as it is an emotional comfort, and so the history of prosthetics is not only a scientific history, but the story of human beings since the dawn of civilization who by birth, wound, or accident were left with something missing."

"“Right on the border of Burma and Thailand, there are landmines like you wouldn’t believe,” he says. These landmines leave many residents as amputees, residents who “would typically never see a prosthesis because of [the] fitting and time it would take.” Armed with Physionetics’ technology and good will, Johnson went to Burma and fitted two amputees with the printed arms. “We donated them,” he says. “All I had to do is go out there, show them how it was fit, and within an hour and a half, we had them on these two guys.” Stories like this are what drive Summit to continue his quest for a “self-use viral app for developing countries” that can create prosthetics. “There will simply never be enough prosthetists to meet their needs.” This isn’t his dream for the future; he thinks it’s a scientific possibility now. And he strongly disagrees that the materials 3-D printing can handle aren’t strong enough to work as limbs. He points out that, “the [human] bones that we have are not as strong as titanium,” a material used in many prosthetic limbs. “When you have great flexibility of geometry, as we do with 3-D printing, you can overcome what strength you don’t have,” Summit says. He says he’s found a way to overcome this strength barrier by creating a hollow prosthetic, then filling it with a lattice structure, similar to the construction of a bird’s bone. “Nature’s been doing this for a long time,” he says."

"“There’s a dream that in the future, we’ll be sitting in our home and hit a button to print our prosthetics from scratch,” Sadler says. “That might be a further out vision.” But some people think we’re already there. Sadler agrees with Kuniholn about the difficulty of attaching printed prosthetics, saying, “The fitting is a whole other black art. 3-D printing only gets you part of the way.” Of course, that’s for high-end prosthetics, the kind you hope to have. In some parts of the world, the choice is between having a mediocrely-fitting prosthetic and not having one at all. This is the situation that spurred Summit to action, as well as Patrice Johnson, who, according to Sadler, is, “the only person to have successfully designed and sold [a] functional upper limb prosthesis that used 3-D printing.”"

"Traditionally, a prosthetist would wrap a stump with plaster of Paris bandages to make a reverse mold and let it dry, then fill it with more plaster that must harden. From this a socket can be forged that fits, with more modifications for precision, to the bone on the stump. Great care must be taken to avoid nerves and tender areas that are not tolerant of pressure. The key for the technician is to understand the pathology of a stump, which differs for each person. This is a cumbersome process that can take a week, especially with gait training for new patients that lasts three days. It can also be messy work, mixing up and molding the plaster, while a prosthetist visiting a rural area must cart around 20-kilo packs of plaster. But with a 3-D scanner, a digital image can be made in half an hour and sent by email, and there is no mess."

"The earliest example of a prosthesis ever discovered is not a leg, arm, or even a fake eye, it’s a toe. A big toe, belonging to a noblewoman, was found in Egypt and dated to between 950-710 B.C.E. We all know that toes are important, but it’s interesting that our earliest physical example of the history of prosthetics is a toe and not something that might seem more important, like a leg or an arm."

"For Wright, the prosthetic had to have a purpose. She wasn’t interested in something that made her look “normal” if it wasn’t going to help her actually do anything better. And she isn’t alone. More and more amputees, engineers, and prospective cyborgs are rejecting the idea that the “average” human body is a necessary blueprint for their devices. “We have this strong picture of us as human beings with two legs, two hands, and one head in the middle,” says Stefan Greiner, the founder of Cyborgs eV, a Berlin-based group of body hackers. “But there’s actually no reason that the human body has to look like as it has looked like for thousands of years.” Greiner himself has magnetic implants in his fingers and an RFID chip in his skin. “We actually already live in a cyborg society,” he said."

"For a long time the history of prosthetics has been inextricably linked with the history of war, and thus of men. After World War II, when soldiers were returning from the battlefield, there was a collective anxiety about whether they’d be able to re-enter their families and workplaces. Many people wanted soldiers to come back, and for everything to go back to normal. But an amputation was a physical reminder that things were not the same. “Physicians, therapists, psychologists, and ordinary citizens alike often regarded veterans as men whose recent amputation was physical proof of emasculation or general incompetence, or else a kind of monstrous de-familiarization of the 'normal' male body,” writes the professor David Serlin in the book Artificial Parts, Practical Lives. Serlin describes the ways in which the media and the military talked about these soldiers, pushing for them to be seen as “normal” in the eyes of the public. In 1946, the comic Gasoline Alley featured a man named Bix whose prosthetic lets him be a “normal American guy.” The comic shows Bix stocking shelves, and features a very surprised boss who exclaims, “I didn’t expect he’d be perfectly normal”—before hiring the man on the spot. Professional photographs taken at Walter Reed Army hospital depicted men with prosthetic devices doing “normal” male activities like lighting a cigarette and reading the sports page, their prosthetic legs adorned with “tattoos” of pinup girls."

"During World War II (1939 to 1945), improved shock management and antibiotics saved lives but resulted in 3475 upper limb amputees in the US (9). The huge demand for artificial limbs led to the creation of a US Committee on Prosthetics Research and Development in 1945 and the Canadian Association of Prosthetics and Orthotics in 1955. The thalidomide tragedy (1958 to 1962) resulted in the birth of many children with shortened limbs, further driving demand and investment for improved prosthetics. In 1948, the Bowden cable body-powered prosthesis was introduced, replacing bulky straps with a sleek, sturdy cable. Despite new materials and improved craftsmanship, today’s body-powered prostheses are essentially adaptations of the Bowden design. Durable, portable and relatively affordable, body-powered prostheses allow the user an impressive range of motion, speed and force in operating a terminal device – most commonly a two-pronged hook – by changing the tension in a cable via preserved shoulder and body movements. The ability to use both hands simultaneously, rather than requiring a healthy hand to control the prosthesis, permits the user to complete tasks more efficiently. Furthermore, by sensing cable tension, the amputee is able to predict and adjust the position of the prosthesis without visual feedback. Although prolonged wearing can be uncomfortable, complicated motor tasks are limited and appearance is not human-like, body-powered prostheses are widely used"

"In 1919, a German book titled Ersatzglieder und Arbeitshilfen (Limb Substitutes and Work Aids) contained conceptual designs for the first externally powered prostheses, using pneumatic and electric power sources. Unfortunately, these revolutionary designs were too complex to be feasible with contemporary technology."

"In 1948, Reinhold Reiter, a physics student at Munich University (Munich, Germany), created the first myoelectric prosthesis, a device that amplifies surface electromyography (EMG) potentials to power motorized parts. Although Reiter published his work, it was not widely appreciated, and this potentially ground-breaking invention did not gain commercial or clinical acceptance."

"World War I (1914 to 1918) resulted in casualties in numbers previously unimagined. In the United States (US), amputee rehabilitation programs were created to help the >4400 amputees, of which the majority (54%) were upper limb, to regain some ability to work on farms or in factories. The distribution of prosthetics with sockets and a universal terminal device allowed the attachment of various work tools. In 1917, the Surgeon General of the US Army is-sued a landmark invitation for limb makers to meet in Washington, DC. The result was the creation of the Association of Limb Manufacturers of America, today the American Orthotic & Prosthetic Association. In Canada, a national charter in 1920 recognized the need to provide support to amputees, leading to the creation of the Amputations Association of The Great War, today known as the War Amps."

"In France and Switzerland, from the late fifteenth through the nineteenth centuries, a variety of custom-designed limbs were built. Made of combinations of wood, metal, Leather|leather, and other materials, some of these designs were truly fantastic. Controlled by cables, gears, cranks, and springs, these limbs could be rotated and bent. There were prosthetic fingers made to grip objects. The limbs were not completely practical, as they had to be operated by a different hand, but they had their uses. For example, a hand could be cranked shut around a pen or fork. Flexing, spring-loaded legs were also available. These fantastic objects were ahead of their time: cable control was a precursor to the standard post-World War II design. Following those early designs, prosthetic limbs improved by leaps and bounds. World Wars I and II, as well as other large-scale conflicts, such as Vietnam, unfortunately increased demand for prosthetics, leading to improvements."

"There is a moment when each ultra-realistic prosthetic limb crafted by Sophie de Oliveira Barata transitions from a hunk of silicon into something more. “It happens around this point,” the artist explained, gesturing to a half-finished leg jutting mid-kick from her work bench. “I’ll know it’s happened when I handle a limb a bit roughly, and I find myself apologizing to it: ‘Oh, sorry!’” It’s an easy mistake to make. With precision molding, hand-painted veins, and real human hairs, the limbs scattered around Sophie’s studio look uncannily real: legs on the verge of dancing and hands ready to burst into applause. With these prostheses, Sophie enables her customers to conceal their absences and blend in. But the artist also caters to another kind of clientele: amputees wanting to stand out. She works with these clients to imagine the missing parts of their bodies as fantastical works of art: an arm housing a motorized coiling snake, a jewel-studded leg with embedded stereo, a bird-wing arm with a metal hook for a talon. “Instead of seeing what’s missing,” she remarked, “you see what’s there.”"

"For the first time, artificial limbs were being mass-produced in response to the enormous number of casualties in World War One. In the US, the Walter Reed Army Hospital produced a large number of artificial limbs for the returning veterans. This example is of a welding attachment and other tools integrated into the limbs for amputees to return to work after the war. It wasn’t all work, however. Also in the collection of the National Museum of Health and Medicine, USA, is an attachment for playing baseball. The Walter Reed Army Hospital is still a centre for artificial limb production in the US, 100 years later. The technology continued to develop after WW1. DW Dorrance invented the split hook artificial hand shortly before World War I. It became popular with labourers after the war who were able to return to work using the attachment because of its ability to grip and manipulate objects. It’s one of the few designs that have remained relatively unchanged over the past century. Dorrance demonstrated its multi-functionality in the 1930s by driving a car using the arm. In the UK, Queen Mary’s Hospital, Roehampton, became a centre for manufacturing artificial limbs in the World War Two. It opened in 1939. In its first year, 10,987 war pensioners attended the centre, with an additional 16,251 limbs being sent by post. At the outbreak of war, the factory was expanded because of the realisation that 40,000 UK servicemen had lost limbs in WW1. However in WW2 there was around half the number of amputees. As Leon Gillis, QMH Consultant Surgeon from 1943-1967, observed, advances in surgical techniques, treatment of infections and the availability of blood transfusion after WW1 all reduced the need for amputation."

"Q: Do the clients always know what they want?"

"People have used all sorts of artificial devices probably from the beginnings of human history to help them compensate for the loss of a limb. Thus in very ancient times, the first and simplest prosthesis may have been a forked tree that was used as a crutch to help someone walk whose leg may have been badly damaged or lost in an accident or to a disease. What began as a modified crutch with a wooden or leather cup and progressed through many metamorphoses has now developed into a highly sophisticated prosthetic limb made of space-age materials."

"Q: Being so focused on other people’s limbs all the time, I wonder, what’s your relationship with your own limbs like?"

"A 3000-year-old mummy was recently discovered sporting a prosthetic big toe. The wooden toe had been meticulously fit to the woman’s foot, with attachment straps designed for comfort. The craftsmanship was extraordinary; the toe could even flex. The toe is one of the oldest examples, but from pirates’ peg legs to Tycho Brahe’s metal nose, replacement body parts have a long and inventive history. Even before the toe’s discovery, prosthetics were known to be ancient technology. Replacement body parts are mentioned prominently in the classical literature of multiple cultures. The mythical Greek hero Pelops, accidentally ingested by the Gods, sported an ivory shoulder after his reconstruction. Herodotus mentions warriors with wooden feet, and there are examples from Asia and Rome as well."

"At a lab at Johns Hopkins University, researchers are building a prosthetic hand unlike any other: It can sense pain. It’s easy to understand why you might want a prosthesis that can feel the squishiness of a grape or the warmth of another person’s hand. But pain? Well, pain could be useful, too. “If you think about how we humans use pain, it’s to protect our bodies, to prevent damage,” says Luke Osborn, a graduate student in Nitish Thakor’s lab at Hopkins, who co-authored a new paper on the pain-sensitive hand. People born without the ability to feel pain stumble through life with dangerous freedom. Babies who do not feel pain are known to chew their fingers raw; children without pain will plunge their hands into boiling water. Pain is a signal that says, Hey, watch out. “People do damage their prosthetic limbs a lot. They use them as tools they weren’t designed to be used as,” says Levi Hargrove, a bioengineer at the Shirley Ryan AbilityLab, who was not involved in the study. It’s easy, for example, to bang an unfeeling piece of plastic and metal against a table. Pain could make a prosthesis feel more real, more lifelike—less a tool and more like a natural part of the body."

"One of the earliest written references to prosthetics is found in a book published in France in 1579. That year, French surgeon Ambrose Pare (1510–1590) published his complete works, part of which described some of the artificial limbs he fitted on his amputees. As a military surgeon, Paré had re-moved many a soldier's shattered arm or leg, and he eventually began designing and building artificial limbs to help the men who had been maimed. Ambroise Paré was the official royal surgeon to four successive kings, and earned his position by practicing medicine on the battlefield, attempting to save, or at least treat, wounded soldiers. As a doctor, he was most disturbed by the reaction of some of the people whom he had saved. He found that some soldiers took their own lives rather than live without limbs, or with terrible wounds. To try to combat this problem, Paré began crafting artificial limbs. This was not new. There is evidence for the use of prostheses from the times of the ancient Egyptians. Prostheses were developed for function, cosmetic appearance and a psycho-spiritual sense of wholeness. Amputation was often feared more than death in some cultures. It was believed that it not only affected the amputee on earth, but also in the afterlife. The ablated limbs were buried and then disinterred and reburied at the time of the amputee’s death so the amputee could be whole for eternal life. One of the earliest examples comes from the 18th dynasty of ancient Egypt in the reign of Amenhotep II in the fifteenth century B.C. A mummy in the Cairo Museum has clearly had the great toe of the right foot amputated and replaced with a prosthesis manufactured from leather and wood. The first true rehabilitation aids that could be recognised as prostheses were made during the civilisations of Greece and Rome. During this period, prostheses for battle and hiding deformity were heavy, crude devices made of available materials—wood, metal and leather. Records of ancient prosthesis can be found all over the world."

"[H]uge number of casualties in the American Civil War caused demand for artificial limbs to skyrocket. Many veterans turned to designing their own prosthetics as a response to the limiting capabilities of the limbs on offer."

"The concept of an ‘automatic’ body-powered upper limb prosthesis was pioneered by German dentist Peter Baliff in 1818. Using transmission of tension through leather straps, Baliff’s device enabled the intact muscles of the trunk and shoulder girdle to elicit motion in a terminal device attached to the amputation stump. For the first time, an amputee was able to operate his prosthesis with fluid body motions, rather than as a distinct foreign object. In the 1860s, the Comte de Beaufort in France adapted the design for use by wounded soldiers. A shoulder harness with a strap buttoned to the trousers was passed through a loop to the contralateral axilla and missing limb, allowing an amputee to manipulate the strap tension to open and close a double spring hook, or flex and extend the thumb on a simple hand with fused fingers. In 1916, German surgeon Dr Ferdinand Sauerbruch described his prosthetic design with digits controlled by transmission of upper arm muscle movements. Video captures from the era show amputees effectively using the prosthesis to drink from a teacup and even to remove a match from a box to light a cigarette. Unfortunately, due to the high cost of production, few individuals were able to afford the device."

"In China, King-his Tse, invented in the 500 b. C. a flying magpie of wood and bam-boo, and a wooden horse able to jump. Around year 200 B.C., Philo of Byzantium, inventor of the repetitive catapult, constructed an aquatic robot. In 206 B.C., the first Han Emperor found the Chin Shih Hueng Ti's treasure. It included a mechanical toy orchestra that moved independently. In old Greece, Archytas of Tarento (referenced in [English]] as Archytas of Tarentum, and in some references in Spanish as Architas de Tarento), philosopher, mathematician and contemporary politician of Plato, considered the father of mechanical engineering and precursory of the robotics, in-vented the [w:Screw|screw]] and the pulley, among other many devices. The materials used for the construction of robots were wood (parts with form), iron (fixed structure, supports, hinges), copper (which is mouldable and allowed the construction of thinner parts), leather (cables, footwear) and fabrics. The first models used the application of direct force to make movements, facilitated with sets of pulleys, gears and handles. In this phase the robots were replicas of the human being that made a series of simple movements. The machines began assuming tasks of aid to the man and ended up repelling their conception of the world and animated beings. The mechanics affected the study of nature, spreading to the anatomy science; of which agreed models with that conception were elaborated, such as “De Humani Corporis Fabrica” (On the workings of the human body) from Andreas Vesalius (1514–1564) who conceived the man as a complex mechanical structure."

"The earliest known prosthesis, dating possibly as far back as 950 B.C., was discovered in Cairo on the mummified body of an ancient Egyptian noblewoman. The prosthesis is made largely of wood, molded and stained, its components bound together with leather thread. It is, as prostheses go, tiny. Because it is a toe. The prosthetic digit—the oldest little piggy in the world—is extraordinarily lifelike, its curved nail sunken into a similarly curved bed. Which is, in its way, remarkable. A toe! One that is several thousand years old! And it's not just a toe-sized peg—a little device that would have made mobility more manageable for someone who was, by reasons of birth or amputation, missing her big toe. The prosthesis is, as much as it possibly could be, humanoid: maximally lifelike and maximally toe-like. The "Cairo Toe," as it's been dubbed, is prosthetic and cosmetic at once—evidence not just of ancient manufacturing stepping in where biology was limited, but of manufacturing engaging in an ancient form of biomimcry. Compare the Cairo Toe to today's prostheses, many of which—especially those that dominate the public imagination—seem to be inspired less by "man," and more by the Bionic Man. The blades. The hooks. The exoskeletons. This week alone has brought news of a roboticized prosthetic hand that, possibly inspired by the workings of the claw crane, foregoes five fingers for three. It has brought news of a woman who created her own prosthetic leg ... out of LEGOs. Those stories come as part of a flood of coverage of the next generation of prostheses, in which technologies from adjacent fields—3D-printing, robotics, chemistry—are helping humans to transcend nature's narrow definition of humanity."

"In a 2013 interview with The New York Times, De Oliveira Barata described her work on prosthetics as outside of engineering or medicine—the industries with which artificial limb-making are typically associated. “Making an alternative limb is like entering a child’s imagination and playing with their alter ego,” she said. “You’re trying to find the essence of the person.” She works with clients to figure out how they want to look. “It’s their choice of how to complete their body—whether that means having a realistic match or something from an unexplored imagination,” she told The Times. These sculptures aren’t accessible to everyone. Wright says she would love a custom leg, but it’s out of reach for her. “I’ve inquired about getting one,” she told me, “but it’s very ex-pensive! Crazy expensive.” Depending on what the limbs are made of, they can cost anywhere from $4,600 to $21,000. But even if not every amputee gets or wants a spike leg or a feathery suit of armor or even the curved cheetah leg, the fact that people see these alternative bodies out in the world seems to have helped push a cultural shift in how people think about normalcy. That is, at least, in Western nations. In many countries, the stigma against disability and amputation remains. In the United States, Mullins says that today’s kids don’t question her normalcy the way her peers once did, they don’t see her as disabled at all. “They see a rebuilt body as something powerful. If I’m walking around in carbon fiber or titanium or bionics, standing on a street corner, and some little kid is walking by, they presume power. They want to know if I can fly, how fast I can run.”"

"For sheer brutality on woman, I do not remember anything in history to match the Malabar rebellion."

"Women are frequently treated as property, they are sold into marriage, into trafficking, into sexual slavery. Violence against women frequently takes the form of sexual violence. Victims of such violence are often accused of promiscuity and held responsible for their fate, while infertile women are rejected by husbands, families and communities. In many countries, married women may not refuse to have sexual relations with their husbands, and often have no say in whether they use contraception [...] Ensuring that women have full autonomy over their bodies is the first crucial step towards achieving substantive equality between women and men. Personal issues—such as when, how and with whom they choose to have sex, and when, how and with whom they choose to have children—are at the heart of living a life in dignity."

"We all grow in a culture in which women's bodies are constantly turned into things, into objects. [...] Of course these affects female self-steem. It also does something even more insidious. It create a climate in which there is wide-spread violence against women. [...] Turning a human being into a thing is the first step towards justified violence against that person."

"The girl was handed over to her family this evening after returning to Iraq"

"Feminism in the United States has never emerged from the women who are most by sexist ; women who are daily beaten down, mentally, physically, and spiritually-women who are powerless to change their condition in life. They are a silent majority. A mark of their victimization is that they accept their lot in life without visible question, without organized protest, without collective anger or rage."

"I woke up that night to the screams of women. I don’t know when I’d fallen asleep, or passed out, but when I woke up, the manic, lost, women were all around me, walking, shambling. I remember that night, my first night in this asylum – I had retreated into the corner, into the shadows, and looked through the bars, bars that had been chained with many locks. The locks were like eyes: the eyes of a man’s vigilance. As I focused, the lock slowly extended to reveal the form of a man, a man sprawling on the bed: I thought of the violence of beds, of my marriage. The man on this bed was my husband – a man who used to beat me metal-blue to eliminate his fear of women. There were other ways of elimination: polishing his black boots and making them shine, washing his clothes, suspending them onto a hanging wire. And the starvation. And the rising lilt of his family’s voices: awaara. A cuss word, a slap – his marriage to me? – The violence of a mongering dog, his teeth digging into my flesh. His skin the color of a chameleon turned blue. Me? I was a churi, a glass bangle. The house? The impersonation of a ghetto. My agency, his anger. So I ran. I ran to a divorce, yes, and I reached my destination after six months of torture. But the six months led to psychosis. So my mother dragged me here, to this mental asylum. Then I woke up, that night, to the screams of women."

"Violence against women and the expropriation of their , as well as the higher level of exploitation of their paid labor, are integral to the way in which power is organized in capitalist society—and how it seeks to divide rather than unify the population. More than a third of women worldwide have experienced physical/. , in particular, are objectified, reified, and commodified as part of the normal workings of monopoly-capitalist marketing."

"I feel officials treated my sister like an animal and killed her"

"She’s used to getting smacked, and won’t give in until you threaten her and really force her."

"Manual restraint, a type of physical restraint, is a common practice in inpatient mental health settings linked to adverse physical and psychological staff and patient outcomes. However, little is known about the use of manual restraint for compulsory nasogastric feeding of patients with anorexia nervosa within inpatient eating disorder settings. The present phenomenological study aimed to explore nursing assistants’ experiences of administering manual restraint for compulsory nasogastric feeding of young persons with anorexia nervosa. The study followed COREQ guidelines. Eight semi-structured interviews were conducted with eight nursing assistants from one UK inpatient child and adolescent eating disorder service. Interviews were transcribed verbatim and analysed using Thematic Analysis. Three themes were extracted: An unpleasant practice, Importance of coping, and Becoming desensitised and sensitised. Nursing assistants commonly experienced emotional distress, physical exhaustion, physical injury and physical aggression as a result of their manual restraint use. Nursing assistants appeared to cope with their distress by talking with colleagues and young persons who were further in their recovery, and by detaching themselves during manual restraint incidents. The findings highlight that the use of manual restraint for compulsory nasogastric feeding of young persons with anorexia nervosa in the UK, is a highly distressing practice for nursing assistants. It is therefore important that sufficient supervision, support and training is made available to staff working in these settings."

"Manual restraint is a form of physical restraint practice, used particularly within inpatient mental health settings, whereby one or more persons restrict the movement of another by manually holding them (Stewart et al., 2009; Stubbs & Paterson, 2011). This differs from mechanical physical restraint which refers to the use of devices (e.g., belts or cuffs) to restrict movement (Care Quality Commission, 2018). Manual restraint is commonly used in conjunction with seclusion and chemical restraint to prevent harm to patients and staff, or to administer medications and other treatments (Chapman et al., 2016; Hawkins et al., 2005; Ryan & Bowers, 2006). For instance, the literature has highlighted the use of manual restraint in response to patient self-harming, aggressive and attempted absconding behaviours (Bowers et al., 2015), and patient medication refusal (Owiti & Bowers, 2011). Concerns have been raised about manual restraint use (Mind, 2013), and internationalguidelines and programmes advocating for its reduction have emerged (e.g., Department of Health, 2014; Mental Health Commission, 2014; O’Hagan et al., 2008; Royal Australian and New Zealand College of Psychiatrists, 2016). Within England alone, over 50,000 incidents of manual restraint were recorded between the years of 2016 and 2017 in National Health Service funded secondary mental health, learning disability (LD) and autism services (Collinson, 2017), demonstrating the commonality of manual restraint practice. This study explores nursing assistants’ experiences of administering manual restraint for compulsory nasogastric feeding (CNF) of young persons with anorexia nervosa (AN)."

"The literature has highlighted the numerous adverse physical and psychological staff outcomes as a result of manual restraint use. Staff have reported experiencing physical exhaustion, physical pain and injury, and numerous unpleasant emotions (e.g., anxiety, fear, anger) as a result of administering manual restraint (Bigwood & Crowe, 2008; Bonner et al., 2002; Chapman et al., 2016; Sequeira & Halstead, 2004; Wilson et al., 2017). Manual restraint has also been linked to staff feelings of internal conflict, as staff may perceive the act of manually restraining patients as incongruent with their therapeutic role (Bigwood & Crowe, 2008; Chapman et al., 2016; Sequeira & Halstead, 2004; Wilson et al., 2017). Although manual restraint is commonly administered within inpatient mental health settings (Stewart et al., 2009; Wilson et al., 2017), the literature has also illustrated its use within the emergency department, LD services, and paediatric general hospital and residential childcare settings (Chapman et al., 2016; Fish & Culshaw, 2005; Lombart et al., 2019; Steckley & Kendrick, 2008; Svendsen et al., 2017). The manual restraint of young persons raises ethical and moral issues for staff, and this has been evidenced by the distress and internal conflict staff may experience when manually restraining young persons (Lombart et al., 2019; Steckley & Kendrick, 2008; Svendsen et al., 2017). For instance, staff have reported feeling guilty when restraining children for medical procedures, with some describing how “difficult and demanding” the process can be (Lombart et al., 2019; Svendsen et al., 2017). Presently, little research has been conducted on the use of manual restraint within child and adolescent settings. However, even less research has been conducted on the use of manual restraint for CNF of patients with AN within inpatient eating disorder settings."

"AN is an eating disorder characterised by an extremely low body weight, a severe restriction of food, a strong desire to be thin, and an intense fear of gaining weight (National Institute of Mental Health, 2018). Under relevant mental health legislation, patients with AN can be administered CNF in extreme cases when they are presenting with very low body weight, and refusing to eat and/or drink (Fuller et al., 2019; Royal College of Psychiatrists, 2014). In the rare case when a patient is resistant to nasogastric feeding, staff members may administer manual restraint to ensure the safety of themselves and the patient during feeding (Fuller et al., 2019, 2020; Neiderman et al., 2001). Within the UK, manual restraint in this context may be used in the absence of other restrictive practices (e.g., seclusion), and may involve holding the patient’s arms, legs and head in a safe position, in order to allow for the safe passing of a nasogastric tube and subsequent feeding (Fuller et al., 2019; Neiderman et al., 2001). Feeding in the context of active resistance is a rare event and raises ethical, legal and clinical issues for all those involved (National Collaborating Centre for Mental Health, 2004). Despite the wealth of research that exists on the treatment of AN, we could only locate one published qualitative study that explored the experience of CNF in the context of AN, including the experience of CNF under manual restraint (Neiderman et al., 2001). In this qualitative survey study exploring children and adolescent patients’, and their parents’ experiences of nasogastric feeding, the authors summarised patients’ nasogastric feeding experiences into two main categories: “I regretted it at the time but think that it was necessary” and “I hated it then and hate it now”. This study however did not focus specifically on the practice of CNF under manual restraint, and did not use in-depth qualitative data collection methods such as individual interviews (the authors used qualitative questionnaires). Studies specifically exploring the experience of CNF under manual restraint from either the patient or staff member’s perspective using in-depth data collection methods, could provide valuable insight into this under-researched practice."