Barriers to obesity communication - Power, habitus and hidden assumptions

Communication on health issues often founders on the avoidance or denial of key messages by intended recipients. This paper explores the development and application of a research methodology combining elements of Pierre Bourdieu’s work on the unconscious nature of practice with Gerhard Maletzke’s psychological model of communication. This combination was designed to elicit deeper responses than those often found in health communication research. This alternative methodological approach was used to evaluate a year-long, city-wide anti-obesity campaign in Sheffield, UK, which targeted key gatekeepers in the message chain; their responses generate useful insights into resistance to uncomfortable communication. The paper concludes with suggestions for addressing communication about obesity and potentially other uncomfortable health and social topics

Life is an Adventure! An agent-based reconciliation of narrative and scientific worldviews\ud

The scientific worldview is based on laws, which are supposed to be certain, objective, and independent of time and context. The narrative worldview found in literature, myth and religion, is based on stories, which relate the events experienced by a subject in a particular context with an uncertain outcome. This paper argues that the concept of “agent”, supported by the theories of evolution, cybernetics and complex adaptive systems, allows us to reconcile scientific and narrative perspectives. An agent follows a course of action through its environment with the aim of maximizing its fitness. Navigation along that course combines the strategies of regulation, exploitation and exploration, but needs to cope with often-unforeseen diversions. These can be positive (affordances, opportunities), negative (disturbances, dangers) or neutral (surprises). The resulting sequence of encounters and actions can be conceptualized as an adventure. Thus, the agent appears to play the role of the hero in a tale of challenge and mystery that is very similar to the "monomyth", the basic storyline that underlies all myths and fairy tales according to Campbell [1949]. This narrative dynamics is driven forward in particular by the alternation between prospect (the ability to foresee diversions) and mystery (the possibility of achieving an as yet absent prospect), two aspects of the environment that are particularly attractive to agents. This dynamics generalizes the scientific notion of a deterministic trajectory by introducing a variable “horizon of knowability”: the agent is never fully certain of its further course, but can anticipate depending on its degree of prospect

Hearing the Hidden Agenda: The Ethnographic Investigation of Procedure

Laser Doppler flowmetry (LDF) is virtually the only non-invasive technique, except for other laser speckle based techniques, that enables estimation of the microcirculatory blood flow. The technique was introduced into the field of biomedical engineering in the 1970s, and a rapid evolvement followed during the 1980s with fiber based systems and improved signal analysis. The first imaging systems were presented in the beginning of the 1990s. Conventional LDF, although unique in many aspects and elegant as a method, is accompanied by a number of limitations that may have reduced the clinical impact of the technique. The analysis model published by Bonner and Nossal in 1981, which is the basis for conventional LDF, is limited to measurements given in arbitrary and relative units, unknown and non-constant measurement volume, non-linearities at increased blood tissue fractions, and a relative average velocity estimate. In this thesis a new LDF analysis method, quantitative LDF, is presented. The method is based on recent models for light-tissue interaction, comprising the current knowledge of tissue structure and optical properties, making it fundamentally different from the Bonner and Nossal model. Furthermore and most importantly, the method eliminates or highly reduces the limitations mentioned above. Central to quantitative LDF is Monte Carlo (MC) simulations of light transport in tissue models, including multiple Doppler shifts by red blood cells (RBC). MC was used in the first proof-of-concept study where the principles of the quantitative LDF were tested using plastic flow phantoms. An optically and physiologically relevant skin model suitable for MC was then developed. MC simulations of that model as well as of homogeneous tissue relevant models were used to evaluate the measurement depth and volume of conventional LDF systems. Moreover, a variance reduction technique enabling the reduction of simulation times in orders of magnitudes for imaging based MC setups was presented. The principle of the quantitative LDF method is to solve the reverse engineering problem of matching measured and calculated Doppler power spectra at two different source-detector separations. The forward problem of calculating the Doppler power spectra from a model is solved by mixing optical Doppler spectra, based on the scattering phase functions and the velocity distribution of the RBC, from various layers in the model and for various amounts of Doppler shifts. The Doppler shift distribution is calculated based on the scattering coefficient of the RBC:s and the path length distribution of the photons in the model, where the latter is given from a few basal MC simulations. When a proper spectral matching is found, via iterative model parameters updates, the absolute measurement data are given directly from the model. The concentration is given in g RBC/100 g tissue, velocities in mm/s, and perfusion in g RBC/100 g tissue × mm/s. The RBC perfusion is separated into three velocity regions, below 1 mm/s, between 1 and 10 mm/s, and above 10 mm/s. Furthermore, the measures are given for a constant output volume of a 3 mm3 half sphere, i.e. within 1.13 mm from the light emitting fiber of the measurement probe. The quantitative LDF method was used in a study on microcirculatory changes in type 2 diabetes. It was concluded that the perfusion response to a local increase in skin temperature, a response that is reduced in diabetes, is a process involving only intermediate and high flow velocities and thus relatively large vessels in the microcirculation. The increased flow in higher velocities was expected, but could not previously be demonstrated with conventional LDF. The lack of increase in low velocity flow indicates a normal metabolic demand during heating. Furthermore, a correlation between the perfusion at low and intermediate flow velocities and diabetes duration was found. Interestingly, these correlations were opposites (negative for the low velocity region and positive for the mediate velocity region). This finding is well in line with the increased shunt flow and reduced nutritive capillary flow that has previously been observed in diabetes

The Organizational Client: Attorney-Client Privilege and the No-Contract Rule

A basic issue in the law governing lawyers is the identification of an attorney\u27s client. Various duties, obligations, and rights arise from the attorney-client relationship. In the case of the individual who is a client, the answer is relatively easy. But in the case of the organizational client, the issue becomes more complex and the answers still are evolving. Indeed, the answer may differ depending on the legal context in which the question is asked and on the individual values being served

The “New Spirit of Academic Capitalism”: Can Scientists Create Generative Critique From Within?

The 21st-century university is a contested site of neoliberal transformation. Its role is moving away from that of a hub of culture, knowledge and critique to that of a provider of skills and employability for the market. The move towards a lean business model in the management of knowledge production is not an isolated phenomenon, but integral to the shifting economic, political and moral landscapes of global capitalism and the knowledge society. The literature discussing the changes in higher education, which could be collectively termed "critical studies of academia", remains fragmented and is yet to yield tangible resistance or envision viable alternative models of academic governance. This article discusses the possibility of generating constructive critique of "the new spirit of academic capitalism" from within. French Convention Theory is employed as a conceptual toolbox for unpacking the worlds of worth, conventions and justifications which operate beneath the surface of the marketisation, acceleration and casualisation of scientific labour - and suggested as a potential tool for building a generative sociology of critique

Trustworthiness and Motivations

Trust can be thought of as a three place relation: A trusts B to do X. Trustworthiness has two components: competence (does the trustee have the relevant skills, knowledge and abilities to do X?) and willingness (is the trustee intending or aiming to do X?). This chapter is about the willingness component, and the different motivations that a trustee may have for fulfilling trust. The standard assumption in economics is that agents are self-regarding, maximizing their own consumption of goods and services. This is too restrictive. In particular, people may be concerned with the outcomes of others, and they may be concerned to follow ethical principles. I distinguish weak trustworthiness, which places no restrictions on B’s motivation for doing X, from strong trustworthiness, where the behaviour must have a particular non-selfish motivation, in finance the fiduciary commitment to promote the interests of the truster. I discuss why strong trustworthiness may be more efficient and also normatively preferable to weak. In finance, there is asymmetric information between buyer and seller, which creates a need for trustworthy assessment of products. It also creates an ambiguity about whether the relationship is one of buyer and seller, governed by caveat emptor, or a fiduciary relationship of advisor and client. This means that there are two possible reasons why trust may be breached: because the trustee didn’t realise that the truster framed the relationship as a fiduciary one, or because the trustee did realise but actively sought to take advantage of the trust. Correspondingly, there are two possible types of agent: normal people who are not always self-regarding and who are trust responsive (if they believe that they are being trusted then they are likely to fulfill that trust), and knaves, after Hume’s character who is always motivated by his own private interest. We can increase the trustworthiness of normal people by getting them to re-frame the situation as one of trust, so they will be strongly trustworthy (i.e. change of institutional culture), and by providing non-monetary incentives (the correct choice of incentive will depend on exactly what their non-selfish motivation is). Knaves need sanctions, which can make them weakly trustworthy. However, this is a delicate balance because sanctions can crowd out normative frames. We can also increase the trustworthiness of financiers by making finance less attractive to knaves; changing the mix of types in finance could help support the necessary cultural change