Population Objects: Interpassive Subjects

While Foucault described population as the object of biopower he did not investigate the practices that make it possible to know population. Rather, he tended to naturalise it as an object on which power can act. However, population is not an object awaiting discovery, but is represented and enacted by specific devices such as censuses and what I call population metrics. The latter enact populations by assembling different categories and measurements of subjects (biographical, biometric and transactional) in myriad ways to identify and measure the performance of populations. I account for both the object and subject by thinking about how devices consist of agencements, that is, specific arrangements of humans and technologies whose mediations and interactions not only enact populations but also produce subjects. I suggest that population metrics render subjects interpassive whereby other beings or objects take up the role and act in place of the subject

Mediating role of C-reactive protein in associations between pre-pregnancy BMI and adverse maternal and neonatal outcomes: the ABCD-study cohort

Objectives: Increased body mass index (BMI) is associated with several adverse pregnancy outcomes, though the underlying mechanism of this association has not been fully elucidated. A mediating role of low-grade systemic inflammation in these associations is suspected but has been understudied. Our objective was to examine the effect of pre-pregnancy BMI (pBMI) on maternal and neonatal pregnancy outcomes and to explore potential mediation of these effects by C-reactive protein (CRP), a first trimester peripheral marker of inflammation. Methods: Data from the prospective community-based ABCD-study cohort (n = 3547) was used to assess associations between self-reported continuous and categorized pBMI and outcome measures gestational hypertension (GH) and preeclampsia (PE), preterm birth (PTB) and small for gestational age (SGA) based on national perinatal registration linkage data. High-sensitivity CRP concentrations determined in serum were used to explore potential mediation of these associations by inflammation. Results: Multivariable logistic regression analyses, adjusted for confounders, showed that pBMI was significantly related to gestational hypertensive disorders (odds ratio (OR) per standard deviation (SD) 1.66, 95% confidence interval (CI) 1.51–1.83) and PTB (OR 1.20, 95% CI 1.05–1.37). Dose–response relationships between categorical pBMI and gestational hypertensive disorders (overweight OR 2.37, 95% CI 1.85–3.03 and obese OR 4.45, 95% CI 2.93–6.72) and PTB (obese OR 2.12, 95% CI 1.16–3.87) were found as well. SGA was only significantly more prevalent in the underweight BMI category (OR 2.06, 95% CI 1.33–3.19). Mediation analyses revealed small but significant indirect effects of pBMI on overall PTB (0.037, bootstrapped 95% CI 0.005–0.065) and spontaneous PTB (0.038, bootstrapped 95% CI 0.002–0.069) through higher CRP. CRP was not a significant mediator of associations between BMI and gestational hypertensive disorders although larger mediation was found for GH than for PE. Conclusion: Our findings provide additional evidence that high(er) pBMI increases the risk of adverse maternal and neonatal outcomes and that systemic inflammation mediates some of these risks. Further research in large cohorts including (morbidly) obese women is warranted to identify pathways that may be incorporated in future interventions to reduce the risk of adverse pregnancy outcomes due to maternal obesity

Met zachte dwang

ARTIKELEN: 1. R. Peeters en M. Schuilenburg - De geest als aangrijpingspunt; de betekenis van gedragssturing in veiligheid, gezondheid en onderwijs 2. G. van Oenen - Eerste hulp bij emancipatie: waarom we nudging nodig hebben 3. A. Zaalberg - Gedragsbeïnvloeding via voeding; enkele toepassingen besproken 4. A. Haans en Y.A.W. de Kort - Indammen van sociale agressie met dynamische verlichting; het De-escalatie-project in Eindhoven 5. H. Elffers - Compliance analyseren met behulp van Willen-Kunnen-Durven-model 6. Internetsites. SAMENVATTING: Nudging ('een duwtje geven') wordt gezien als een van de meest veelbelovende technieken om burgers te helpen een goede gedragskeuze te maken, zonder inbreuk te maken op hun keuzevrijheid. In deze aflevering wordt enerzijds het fenomeen nudging nader geanalyseerd en theoretisch geduid. Anderzijds is er aandacht voor resultaten van wetenschappelijk onderzoek op o.a. de terreinen van gedragspsychologie en voedingsleer, die eventueel deel kunnen uitmaken van een alternatieve strategie om menselijk gedrag te beïnvloeden. Ook wordt aandacht besteed aan een analyse-instrument voor wet- en regelgeving dat kan helpen om te bepalen op welk niveau een interventie (nudging of anderszins) ter bevordering van compliance, nuttig is