Reconceptualising public acceptability: A study of the ways people respond to policies aimed to reduce alcohol consumption.

This is the final version of the article. It first appeared from SAGE Publications via http://dx.doi.org/10.1177/1363459315574117The issue of public acceptability of health policies is key if they are to have significant and lasting impact. This study, based on focus groups conducted in England, examines the ways people responded to, and made sense of, policy ideas aimed at reducing alcohol consumption. Although effective policies were supported in the abstract, specific proposals were consistently rejected because they were not thought to map onto the fundamental causes of excessive drinking, which was not attributed to alcohol itself but instead its cultural context. Rather than being influenced by the credibility of evidence, or assessed according to likely gains set against possible losses, such responses were established dynamically as people interacted with others to make sense of the topic. This has significant implications for policy-makers, suggesting that existing beliefs and knowledge need to be taken into account as potentially productive rather than obstructive resources.The author disclosed receipt of the following financial support for the research, and publication of this article: The UK Department of Health Policy Research Programme (Policy Research Unit in Behaviour and Health, PR-UN-0409-10109)

Dynamic friction measurement, modeling, and compensation for precise motion control

In this thesis, measurements of dynamic friction in a hydrodynamic journal bearing were performed for varying sinusoidal velocity excitations, loads, and lubricants. The results indicate that the friction data displays a negative slope in the mixed region of friction vs. velocity (f-v) curves, and also shows that the dynamic friction is not just a function of current velocity, but also a function of velocity history (hysteresis). These results are in agreement with previous experimental investigations by other investigators in lubricated friction. Secondly, a dynamic friction model is fully explored and partially extended to provide quantitative agreement to measured friction values. A contribution to friction modeling was made by reducing the model from a fourth to a second order equation. Parameters were determined for one lubricant and two non-nal loads, and the model output is compared to experimental data. Finally, model-based friction compensation was successfully performed. The dynamic friction model is used as a basis for velocity and position control of an apparatus with high friction by incorporating a function to constantly learn two parameters of the model. Results demonstrate the feasibility of using a rich friction model in real time, and its ability to greatly reduce the tracking errors caused by friction. This thesis was supported by the National Science Foundation under Grant MSS9215636

Beyond the person: the construction and transformation of blood as a resource

Many studies of blood donation have looked at the motives of donors, their relationship with the wider society and corresponding values such as gift-giving, altruism and responsibility. These underpin a rhetorical representation of person-to-person donation that neglects the many technical processes that take place between donation and eventual use and the material nature of blood itself. This ethnographic study, conducted in four UK blood donation sites, describes the various practices involved in routine sessions, rather than the motives or values or donors or staff. It focuses on the procedures and equipment that not only ensures blood is collected safely and efficiently, but the extent to which they determine the nature of the collected blood itself. Taking our cue from posthuman approaches, we argue donated blood as something that is ‘made’ only when it leaves the body; in other words, it is not simply extracted, but is constructed through specific practices. We illustrate how, as blood is separated from the body, it is increasingly depersonalised and reconstituted in order to have biomedical value. In this way, rather than reproducing the essentialist claim that blood is what social scientists often described as a ‘special kind of substance’, we point to the ways in which donated blood alters as it moves in time and space. We argue that such transformations occur in both symbolic and material realms, such that the capacity of blood to have both cultural meaning and clinical value is dependent on the fact that it is never stable or singular

Placing death and dying:the work of making place at the end of life

Background: Palliative care policy and professionals are concerned about the location of care, epitomised in phrases like ‘preferred place of care’ and ‘preferred place of death’. There has been an emphasis on home being the ideal place. Conversely, it is recognised that high quality palliative and end-of-life care can be delivered in a wide variety of settings. Methods: This presentation is part of the ongoing Forms of Care project about palliative care. Ethnographic methods include observation of over 60 in- and outpatient palliative care team meetings, 1 year of shadowing palliative care team members in their daily work, and 15 interviews with palliative care staff, including doctors, nurses, social workers, and physiotherapists. Three patients and their families were also interviewed multiple times. Data was thematically analysed, drawing on social theory. Results: Palliative care professionals consider place as part of the care they deliver. Hospital was typified as a place of control, known infrastructure, skilled staff and support, and constant monitoring. The home was a place of being a ‘guest’ and unknown quantity, creating a shift in power dynamics between professionals, and patients and their families. The drive for patients to be cared for at home came with added costs in terms of resources and the emotional labour. However, many cases extended beyond this binary. We highlight the work both professionals and patients do to keep a place stable. We suggest such efforts of ‘placing’ show how place is not merely a geographical location, but made through relations, interactions and activities. Conclusion: In the push to enable patients to die at home, what tends to be overlooked is the work that goes into ‘placing’: the work of ‘making place’. The research indicates the importance of understanding how placing gets done as a form of car

‘We come in as “the nothing”’

In our ethnographic study of palliative care in a UK medical setting, we concerned ourselves with instances when medical staff chose not do something, which we came to call ‘noninterventions’. Such instances raised an obvious question: how does one study something that is not happening? In this Position Piece, we outline three ways in which we have tried to engage with this methodological question, from the initial grant application process to the point we are at now: first, a somewhat positivist approach, which allowed us to delineate the phenomenon of our study; second, a following technique, adopted to understand noninterventions as and when they are conceived by our informants; and third, an approach that tries to trace enactments of ‘not doing’ by mapping the range of different practices and, in so doing, elucidates how ‘not doing’ invariably occurs alongside other forms of doing. We describe what these approaches have taught us so far and reflect on the limits of each. We do so in the hope of providing others with starting points for studying nothings, ‘not doings’, and absences

‘We come in as “the nothing”’: Researching non-intervention in palliative care

In our ethnographic study of palliative care in a UK medical setting, we concerned ourselves with instances when medical staff chose not do something, which we came to call ‘noninterventions’. Such instances raised an obvious question: how does one study something that is not happening? In this Position Piece, we outline three ways in which we have tried to engage with this methodological question, from the initial grant application process to the point we are at now: first, a somewhat positivist approach, which allowed us to delineate the phenomenon of our study; second, a following technique, adopted to understand noninterventions as and when they are conceived by our informants; and third, an approach that tries to trace enactments of ‘not doing’ by mapping the range of different practices and, in so doing, elucidates how ‘not doing’ invariably occurs alongside other forms of doing. We describe what these approaches have taught us so far and reflect on the limits of each. We do so in the hope of providing others with starting points for studying nothings, ‘not doings’, and absences

Constructing denial as a disease object: accounts by medical students meeting dying patients

As part of the general shift in contemporary healthcare from a focus on specific diseases to treating the whole person, doctors are now expected to be reflective and engage empathetically with patients. Yet, the context of end of life potentially confounds this commitment. Here we draw on the written submissions of UK medical students confronting dying patients to offer insight into a range of entangled issues. Although the exercise is designed to highlight the value of listening to patients and to encourage reflective practice, the experience of ultimately not being able to treat or cure frequently challenges the students’ understanding of the central purpose of clinical care and their future role as doctors. Because they invariably draw on the notion of ‘good death’, whenever they have to make sense of patient behaviour deemed as irrational or obstructive the students employ the concept of ‘denial’ as a strategic category. In this context denial is referred to as a disease-like object that the students feel they can, and should, diagnose and treat. Such conceptual operations consequently illustrate a tension arising from trying to acknowledge the value of a whole-patient approach while simultaneously reproducing the emphasis placed on identifying those discrete elements that determine legitimate medical intervention

The contribution of media analysis to the evaluation of environmental interventions: the commuting and health in Cambridge study.

BACKGROUND: Media content can increase awareness of, and shape interactions with, public health interventions. As part of a natural experimental evaluation of the travel, physical activity and health impacts of the Cambridgeshire Guided Busway, we analysed print and social media discourse and interview data to understand the nature of new transport infrastructure and how it was experienced. METHODS: Newspaper articles were systematically retrieved from the LexisNexis database and tweets were identified from an online archive. Interviews were conducted as part of the larger evaluation study with 38 adults. Inductive thematic analysis was performed and comparisons were drawn between datasets. RESULTS: The findings are discussed in relation to five themes. First, an understanding of the intervention context and how the intervention was experienced was developed through accounts of events occurring pre and post the busway's opening. Second, the media captured the dynamic nature of the intervention. Third, the media constructed idealised portrayals of the anticipated busway which in some cases were contradicted by the impact of the busway on the existing context and people's lived experiences. Fourth, differential media coverage of the intervention components suggested that a lesser value was placed on promoting active travel compared with public transport. Lastly, interview data provided support for the hypothesis that the media increased awareness of the busway and served as a frame of reference for constructing expectations and comparing experiences. CONCLUSIONS: This analysis has contributed to the wider evaluation of the busway, helping to understand its nature and implementation and informing hypotheses about how the local population interact with the infrastructure by attending to the significance of representations in the media