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BACKGROUND: Celiac disease (CD) is underdiagnosed and associated with diagnostic delays. This has long-term consequences for the health and well-being of people living with the condition. Little is known about the qualitative configurations of the assessment processes of people living with CD. METHODS: Using a thematic network analysis of 24 in-depth interviews, this study explored the experiences of people living with CD related to their assessment processes leading to being diagnosed. RESULTS: A significant diagnostic delay (up to 26 years) was evident in many interviews. Factors contributing to diagnostic delay included limited knowledge about CD among general practitioners (GP) and in the general population, categorisations of symptoms as 'typical' or 'atypical' and psychosomatic explanations of symptoms. Diagnostic delay resulted in (1) decreased psychological well-being due to severe symptoms, changes in self-perception and self-blame; (2) decreased physiological well-being due to comorbidities; and (3) mistrust in the healthcare system, leading to an increase in informants' responsibility for expediting their assessment processes. This suggested the presence of a neoliberal tendency because informants felt they were primarily responsible for their assessment processes. CONCLUSIONS: We encourage the implementation of initiatives to increase awareness of CD among GPs as well as more consistent and frequent use of the screening guideline due to variations in its clinical presentation. Increased awareness and consistency could reduce variations in assessment processes given GPs' varying knowledge about the condition.

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To address some challenges facing psychiatrists today we discuss issues of happenstance and fulfilment in psychiatric careers through some of the record and reflections of four psychiatrists since the 1950s. We trace the changes in psychiatry attendant to the transition from the welfare to the neoliberal state and=its contemporary postmodern culture. We highlight the crucial importance of political-cultural as well as technological developments in determining psychiatric service management and provision, and clinical practice and career outcomes. In the light of this impact, in a global era that some highly respected authorities consider in apocalyptic terms, we advocate for the incorporation of training in political awareness and activism in the psychiatric curriculum and practice. We suggest that this is necessary for social justice and patient welfare and that it will help safeguard psychiatric professionalism, conscience and self-esteem.

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Employment conditions are important social and commercial determinants of health. Informal employment-also known as 'cash-in-hand' and 'undeclared' work-is a discrete employment condition that has salience around the world. Fuelled by neoliberal ideology, informal employment has become increasingly common in high-income countries. Public health research concerning the health of informal workers comes largely from low- and middle-income countries, where the phenomenon is more visible. There has been little research on the health effects of informal employment in high-income countries including Australia. Twenty-nine workers aged 18 years and older, who were undertaking informal work activities, were recruited using social media and an online marketplace in Tarndanya (Adelaide-Kaurna Country), Australia. Qualitative narrative data, demographic profiles, and physical and mental health scores were collected. Most informal workers reported unfair and indecent employment conditions including job insecurity, low income, coercion, and lack of respect and dignity at work, and were often exposed to unsafe and unhealthy work environments. Workplace injuries and exposure to occupational hazards were common; and Physical and Mental Component Scores were poorer among informal workers when compared to the population of South Australia as a whole. With informal employment in Australia described as part of a 'significant, pervasive, damaging and growing' problem, there is a need for a health promotion lens over industrial relations policies in the interest of creating equitable access to fair and decent work.

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The well-being of health care workers (HCWs) and the public in Ontario, Canada is at risk as the province's health care system is strained by neoliberal restructuring and an aging population. Deteriorating working conditions that preceded the COVID-19 pandemic further declined as the added challenges took their toll on the work force, physically and mentally. The pandemic-weary hospital staff, predominantly women, many racialized, are facing unprecedented challenges. They are experiencing stress, anxiety, and burnout from staffing shortages and the resulting increased workloads, long hours, and violence. Comprehensive telephone interviews were conducted with 26 HCWs from less highly paid occupations in a range of hospitals across the province. Thematic analysis reveals a critical need for policies and legislation ensuring increased funding, hospital capacity, and reduced wait times while providing HCWs with fair and equitable wages, increased staffing, mental health supports, greater respect and acknowledgment, and strong protections from violence and other workplace hazards.

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Concerns about research's environmental impacts have been articulated in the research arena, but questions remain about what types of role responsibilities are appropriate to place on researchers, if any. The research question of this paper is: what are the views of UK health researchers who use data-intensive methods on their responsibilities to consider the environmental impacts of their research? Twenty-six interviews were conducted with UK health researchers using data-intensive methods. Participants expressed a desire to take responsibility for the environmental impacts of their research, however, they were unable to consolidate this because there were often obstacles that prevented them from taking such role responsibilities. They suggested strategies to address this, predominantly related to the need for regulation to monitor their own behaviour. This paper discusses the implications of adopting such a regulatory approach as a mechanism to promote researchers' role responsibilities using a neo-liberal critique.

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BACKGROUND: Concern is growing over the power, influence, and threats to health and equity from the operations of large global consultancy firms. Collectively, these firms support a neoliberal policy environment promoting business interests ahead of public health. Global consultancy firms act as commercial determinants of health, an evolving area of research over recent years. However, this research mainly focuses on specific corporations or industry sectors, especially those which produce harmful products, including ultra-processed food, alcohol, and fossil fuels. It is therefore important to expand the focus to include large global consultancy firms and place a public health and equity lens over their operations. MAIN BODY: Global consultancy firms have wide-ranging conflicts of interest. These arise from the 'revolving door' employment strategies between their own staff and those from government and regulatory bodies. These firms also advise governments on taxation and other matters while concurrently advising corporate clients on ways to minimise taxation. They advise fossil fuel corporations while also advising governments on climate and health policies. These firms undermine the capabilities of the public sector through the outsourcing of traditional public sector roles to these private interests. Consultancy firms foster private interests through their engagement with the higher education sector, and thereby weaken the tradition of transparent management of university affairs by accountable university councils. While private consultancies cannot be blamed for all the negative consequences for health and equity caused by the problems associated with globalisation and advanced capitalism, they have played a role in amplifying them. CONCLUSION: Addressing the negative impacts of global consultancy firms will require strengthening the public sector, enforcing greater transparency, accountability, and minimising conflicts of interest. It will also demand critical thought, counter discourses, and activism to reframe the narratives supporting neo-liberal ideas of governance that are promoted in both government and business arenas.

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Neuroscience attracted increasing attention in mass media during the last decades. Indeed, neuroscience advances raise high expectations in society concerning major societal issues such as mental health and learning difficulties. Unfortunately, according to leading experts, neuroscience advances have not yet benefited patients, students and socially deprived families. Yet, neuroscience findings are widely overstated and misrepresented in the media. Academic studies, briefly described here, showed that most data misrepresentations were already present in the neuroscience literature before spreading in mass media. This triumphalist neuroscience discourse reinforces a neuro-essentialist conception of mental disorders and of learning difficulties. By emphasizing brain plasticity, this discourse fuels the neoliberal ethics that overvalue autonomy, rationality, flexibility and individual responsibility. According to this unrealistic rhetoric, neuroscience-based techniques will soon bring inexpensive private solutions to enduring social problems. When considering the social consequences of this rhetoric, neuroscientists should refrain from overstating the interpretation of their observations in their scientific publications and in their exchanges with journalists.

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"Neorecovery" is a portmanteau used to describe the distortions that neoliberalism engendered in the original recovery philosophy. I describe how neoliberalism as an economic model acted externally to the recovery movement to preclude opportunities to implement a wide range of innovative mental health approaches and to curtail safety net and social justice policies for persons with severe mental illness. In addition, I illustrate how the neoliberalism philosophy acted internally by inducing the recovery movement to adopt an individual-focused ethos that minimized the impact of broader social structures that affect well-being and opportunities for self-realization. Recovery's potentially radical transformative vision can only be achieved by seriously acknowledging the social and political structures that underlie the mental health system and their relationship to the broader society, and ultimately, altering them so that people experiencing severe mental illness can truly flourish.

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Class-based perspectives on the persistent social gradients in health within modern welfare states largely focus on the adverse consequences of unfettered neoliberalism and entrenched meritocratic socioeconomic selection. Namely, neoliberal-driven economic inequality has fuelled resentment and stress among lower-status groups, while these groups have become more homogeneous with regard to health behaviours and outcomes. We synthesise several sociological and historical literatures to argue that, in addition to these class-based explanations, socioeconomic inequality may contribute to persistent social gradients in health due to elite class self-interest-in particular elites' preferences for overdiagnosis, overprescription and costly high-technology medical treatments over disease prevention, and for increased tolerance for regulatory capture. We demonstrate that this self-interest provides parsimonious explanations for several contemporary trends in U.S. health inequality including (A) supply-side factors in drug-related deaths, (B) longitudinal trends in the social gradients of obesity and chronic disease mortality and (C) the immigrant health advantage. We conclude that sociological theories of elite class self-interest usefully complement theories of the psychosocial effects of neoliberalism and of meritocratic social selection while answering recent calls for research on the role advantaged groups play in generating inequalities in health, and for research that moves beyond technological determinism in health sociology.

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The arrival of Afro-descendant migrants, mainly from Haiti and the Dominican Republic, has led to the emergence of new discourses on migration, multiculturalism, and mental health in health services in Chile since 2010. In this article, I explore how mental health institutions, experts, and practitioners have taken a cultural turn in working with migrant communities in this new multicultural scenario. Based on a multisited ethnography conducted over 14 months in a neighbourhood of northern Santiago, I focus on the Migrant Program-a primary health care initiative implemented since 2013. I argue that health practitioners have tended to redefine cultural approaches in structural terms focusing mainly on class aspects such poverty, social stratification, and socioeconomic inequalities. I affirm that this structural-based approach finds its historical roots in a political and ideological context that provided the conditions for the development of community psychiatry experiences during the 1960s and 1970s, as well as in multicultural and gender policies promoted by the state since the 1990s. This case reveals how health institutions and practitioners have recently engaged in debates on migration and intersectionality from a structural approach in Chile.

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This article analyzes how liberal, American-curriculum universities and neoliberal entrepreneurship centers play a role in shaping the religious subjectivities of millennial Muslim women in the United Arab Emirates (UAE). It is grounded in 2 years of fieldwork and interviews conducted with middle-class, migrant Muslim women living in the UAE, a highly cosmopolitan urban setting shaped deeply by processes of globalization. Examining how 'global forms' materialize in local contexts, the article scrutinizes how the 'assemblages' emerging in educational and entrepreneurial contexts play a vital role in shaping women's practices and sensibilities, conceptualizations of God, and relationships to others. Tracing one woman's intellectual and religious trajectory through her self-narrative, the article intervenes in debates on the global reach and resonance of American educational 'imperialism'; the entanglement of religious and entrepreneurial subjectivity; and the contemporary forms of Islamic religiosity in the Middle East.

Cet article analyse comment les universités libérales à programme américain et les centres d'entrepreneuriat néolibéraux jouent un rôle dans la formation des subjectivités religieuses des femmes musulmanes de la génération Y des Émirats arabes unis (EAU). L'étude s'appuie sur deux années de travail de terrain et et sur des entretiens avec des femmes musulmanes migrantes de classe moyenne vivant aux Émirats arabes unis, un environnement très urbain et cosmopolite profondément marqué par les processus de mondialisation. En examinant comment les « formes globales ¼ se matérialisent dans les contextes locaux, l'article étudie comment les « assemblages ¼ émergeant dans les contextes éducatifs et entrepreneuriaux jouent un rôle essentiel dans la formation des pratiques et des sensibilités des femmes, dans leur conceptualisation de Dieu et dans leurs relations avec les autres. En retraçant la trajectoire intellectuelle et religieuse d'une femme à travers son récit personnel, l'article intervient dans les débats sur la portée et la résonance mondiales de l'« impérialisme ¼ éducatif américain, sur l'enchevêtrement de la subjectivité religieuse et entrepreneuriale et sur les formes contemporaines de la religiosité islamique au Moyen-Orient.

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Scholarly debate over the transformative potential of neoliberal, market-based, food movement strategies historically contrasts those who value their potential to reform the food-system from the inside against those who argue that their use concedes the primacy of the market, creates citizen-consumers, and undermines overall movement goals. While narrow case studies have provided important amendments, the legacy of such strategies requires impacts to be evaluated both contextually and more broadly than the specific activism. This study thus conceptualizes the 'case' of U.S. biotechnology market activism expansively, drawing on interviews with 25 activists from diverse organizations to investigate the legacy of two food-labeling movement strategies (one public and mandatory, one private and voluntary). The results support that the legacy of market strategies extends more broadly than the immediate initiative. They also confirm that the consequences of such neoliberalized strategies are most productively assessed contextually and applied, rather than categorically-as most clearly illustrated by the counterintuitive results of the failed mandatory labeling effort. Of the two market strategies, voluntary labeling demonstrated the most problematic relationship to broader movement goals of food system transformation, in part because of the greater potential for overlapping credence claims and in part due to the risks of niche market logic.

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Despite self-congratulatory rhetoric, Canada compromised COVID-19 vaccine equity with policies impeding a proposed global waiver of vaccine intellectual property (IP) rules. To learn from Canada's vaccine nationalism we explore the worldview - a coherent textual picture of the world - in a sample of Government of Canada communications regarding global COVID-19 vaccine sharing. Analysed documents portray risks and disparities as unrelated to the dynamics and power relations of the Canadian and international economies. Against this depoliticised backdrop, economic growth fueled by strict IP rules and free trade is advanced as the solution to inequities. Global vaccine access and distribution are pursued via a charity-focused public-private-partnership approach, with proposals to relax international IP rules dismissed as unhelpful. Rather than a puzzling lapse by a good faith 'middle power', Canada's obstruction of global COVID-19 vaccine equity is a logical and deliberate extension of dominant neoliberal economic policy models. Health sector challenges to such models must prioritise equity in global pandemic governance via politically assertive and less conciliatory stances towards national governments and multilateral organisations. Mobilisation for health equity should transform the overall health-damaging macroeconomic model, complementing efforts based on specific individual health determinants or medical technologies.

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BACKGROUND: In recent decades, there has been a significant transformation in the world of work that is characterized by a shift from traditional manufacturing and managerial capitalism, which offered stable full-time employment, to new forms of entrepreneurial capitalism. This new paradigm involves various forms of insecure, contingent, and non-standard work arrangements. Within this context, there has been a noticeable rise in Self-Employed individuals, exhibiting a wide range of -working arrangements. Despite numerous investigations into the factors driving individuals towards Self-Employment and the associated uncertainties and insecurities impacting their lives and job prospects, studies have specifically delved into the connection between the precarious identity of Self-Employed workers and their overall health and well-being. This exploratory study drew on a 'precarity' lens to make contributions to knowledge about Self-Employed workers, aiming to explore how their vulnerable social position might have detrimental effects on their health and well-being. METHODS: Drawing on in-depth interviews with 24 solo Self-Employed people in Ontario (January - July 2021), narrative thematic analysis was conducted based on participants' narratives of their work experiences. The dataset was analyzed with the support of NVIVO qualitative data analysis software to elicit narratives and themes. FINDINGS: The findings showed that people opt into Self-Employment because they prefer flexibility and autonomy in their working life. However, moving forward, in the guise of flexibility, they encounter a life of precarity, in terms of job unsustainability, uncertainties, insecurities, unstable working hours and income, and exclusion from social benefits. As a result, the health and well-being of Self-Employed workers are adversely affected by anger, anomie, and anxiety, bringing forward potential risks for a growing population. CONCLUSION AND IMPLICATIONS: Neoliberalism fabricates a 'precariat' Self-Employed class. This is a social position that is vague, volatile, and contingent, that foreshadows potential threats of the health and wellbeing of a growing population in the changing workforce. The findings in this research facilitate some policy implications and practices at the federal or provincial government level to better support the health and wellbeing of SE'd workers.

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In recent years, a wide range of contributions have sought to conceptualize the emergent effects of platforms on contemporary capitalism(s). One strand of literature has emphasized the novelty of platforms, stressing their disruptive features and proclaiming the rise of a new era - platform/digital capitalism. Another strand has tended to position platforms within the longue durée of capitalist transformation, focusing on the continuities and historical recurrences of platform-led transformations. In contrast to both strands of literature, this paper argues that platforms should be understood as reworking existing, neoliberal institutions from within, engendering a process of hybridization. It builds on the French Régulation approach to trace platform-led transformations in the wage relation and social reproduction. It argues that platforms have consolidated their dominance in the post-2008 financial crisis period by, on the one hand, inserting themselves into neoliberal 'innovations' in labor markets, benefitting from a flexibilized, precaritized and casualized workforce and, on the other, by responding to the neoliberal crisis in social reproduction, and the decades-long privatization, marketization and individualization of reproductive tasks. It explores these dynamics in the context of Amsterdam and Berlin, tracing the hybridization of the neoliberal wage-labor nexus in the context of food delivery, cleaning and care platforms.

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Yoga has become a popular health and wellbeing practice that draws on ancient philosophy. Pratyahara is a core tenet of yoga practice and is often translated to mean withdrawal of the senses. Withdrawing from the senses plays a key role in aiding yoga practitioners to find spiritual enlightenment by transcending the worldly. Withdrawing from the material world, however, does not neatly fit within the parameters of the contemporary postural yoga industry. This paper looks at the conceptual origins of pratyahara through stances relevant to health research. The author weaves biomedical, esthetic, and neoliberal onto-epistemological stances through health discourse to discuss how postural yoga both resists and replicates power imbalances. In so doing the author emphasizes the paradoxical nature of pratyahara as it is reflected in socio-political tensions of the yoga industry. To conclude, the author suggests that pratyahara itself can be useful in resolving this tension as yoga fulfills a philosophical prerogative for social change.

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Climate emergency is a planetary health and systems science challenge because human health, nonhuman animal health, and the health of the planetary ecosystems are coproduced and interdependent. Yet, we live in a time when climate emergency is tackled by platitudes and weak reforms instead of structural and systems changes, and with tools of the very same systems and metanarratives, for example, infinite growth at all costs, that are causing climate change in the first place. Seeking solutions to problems from within the knowledge frames and metanarratives that are causing the problems reproduces the same problems across time and geographies. This article examines and underlines the importance of an epistemological gaze on knowledge economy, an epistemological X-ray, as another solution in the toolbox of decolonial and other social justice struggles in an era of climate emergency. Epistemology questions and excavates the metanarratives embedded in knowledge forms that are popular, dominant, and hegemonic as well as knowledges that are silent, omitted, or erased. In this sense, epistemology does not take the "archives" of data and knowledge for granted but asks questions such as who, when, how, and with what and whose funding the archive was built, and what is included and left out? Epistemological choices made by innovators, funders, and knowledge actors often remain opaque in knowledge economies. Epistemology research is crucial for science and innovations to be responsive to planetary society and climate emergency and mindful of the social, political, neocolonial, and historical contexts of science and technology in the 21st century.

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In contemporary and popular discourse, imposter syndrome is frequently outlined as an individual problem that can be overcome. Rather than the locus of responsibility being placed on the individual, we posit that neoliberal academic institutions contribute to imposter syndrome by (de)legitimising certain forms of knowledge.

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The term 'resilience' has become a fashionable buzzword infiltrating mental health services globally. This latest ad nauseam has become both an irritation and insult to service users and mental health professionals alike. We argue resilience is a flawed Western theory of suffering aligned with neoliberal ideology. It is a double-edged sword indiscriminately yielded at both service users and staff. This paper examines the origins and evolution of resilience, and how mental health services have morphed resilience into a meaningless slogan, causing iatrogenic harm. We call for mental health professionals to consider their use of language and the intended or unintentional meaning behind their choice of words.

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Informal employment has been identified as an important social determinant of health. This article addresses the processes through which informal employment affects workers' health in Chile. The study's methodological approach was based on qualitative interviews with 34 formal and informal workers. The findings show how workers perceive informal employment as negatively affecting their mental and physical health through different dimensions of their living and working conditions. Incorporating a gender perspective proves to be integral to the analysis of these processes. The article concludes by discussing how neoliberalism underlies such vulnerability processes and negatively impacts on the population's health.

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