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"I never held a public office in my life during which I was not under some kind of threat of removal or impeachment from the day I went into politics until the present day. I have never held one, and I do not expect to hold one." Huey P Long, American Progress, 8 February 1934. When, in March 1929, just ten months after he was inaugurated as governor of Louisiana, Huey P Long had been impeached by the state's Legislature, he was one of only a handful of state governors to have been censured in this way in United States history. Despite the rarity of impeachment, the action against Long has been under-examined by academics and historians, with previous work focussing solely on a recitation of events and speculation that the action may have wrought a possible alteration in his personality. However, the impeachment had a more profound and transformational impact on Long and his subsequent career, leading as it did to actions which, without this tipping point, may not have occurred in quite the same way. Therefore to dismiss the impeachment as a simple vignette in the sometimes controversial career of Long, is to under-estimate the importance of the action and its subsequent impact. To redress this omission, it is necessary to examine the genesis of the impeachment in 1929 and to determine whether the action was a predictable event based on a broad view of Long, his character and his techniques, his personal and political belief systems, his position within the state of Louisiana and the South, and the environment in which he emerged to prominence. Through this wider approach, it has been possible to trace the origins of the 1929 impeachment to its roots in Long's early political career.

Background: Moderate to severe chronic pain affects one in five of adults. The prevalence and impact of pain increase with age. Pain may increase the risk of mortality but the relationship is not clear. Aims: To test the hypothesis that pain increases the risk of mortality, to test if the relationship was dependent on pain classification and identify mediators and moderators of the relationship. Methods: A systematic review and meta-analysis evaluated existing evidence. Survival analyses (Cox’s proportional hazard modelling and a novel technique to assess mediation within survival models) were conducted on two large population studies of adults aged ≥50 years; the English Longitudinal Study of Ageing (ELSA) (n=6324) and the North Staffordshire Osteoarthritis Project (NorStOP) (n=10985). Lifestyle, health, social and psychological factors were tested as potential mediators. Sex and comorbidity were tested as moderators. Results: In the systematic review pooled analysis from 7 studies revealed a modest but non-significant risk of mortality for people with chronic pain (Mortality Rate Ratio 1.14, 95%CI (0.95, 1.37)). In survival analyses the relationship with mortality was influenced by pain classification: pain that was troubling (1.29 (1.12, 1.49)) or that interfered with daily activities (1.88 (1.54, 2.29)) was associated with an increased risk of mortality while reporting any pain was not (1.06 (0.95, 1.19)). The strongest mediators in ELSA that were replicated in NorStOP were functional limitation (Hazard Ratio 1.31; 95%CI (1.20, 1.39)), physical inactivity (1.14 (1.10, 1.20)) and poor self-rated health (1.32 (1.23, 1.41)). Sex and comorbidity moderated the extent of some mediating pathways (e.g. depression) but the findings were inconsistent between datasets. Conclusion: Specific opportunities to reduce mortality risk for people with pain were identified. At a population level, mortality risk for people with pain could be reduced by the effective management of pain and its impact.