The Subject of Functional Foods: Accounts of Using Foods Containing Phytosterols

This paper explores the notion of the late modern or reflexive subject, for whom consumption, rationality, autonomy and a reflexive attitude to risk are said to be constitutive. Drawing on an example of \'ordinary\' health consumption (Gronow and Warde, 2001), the paper addresses what kinds of consumer identities emerge in people\'s talk about buying or eating foods containing phytosterols. These are \'functional foods\' which are marketed on the basis that they actively lower cholesterol. Based on interviews with people who say that they buy or eat these foods, the analysis focuses on participants\' reported trajectories relating to how this came about. Participants\' accounts contain a number of explicit and implicit reasons for buying or eating the foods, which I characterise as agential, contextual, or non-agential, depending on the degree to which they draw on the agency of the actual purchaser or eater. These different types of explanations can be ordered in terms of their appeals to rationality, risk consciousness and autonomy. In agential explanations, people talk, for example, of doing something good for themselves, or experimenting with the foods. These explanations explicitly position consumers as health conscious, autonomous and rational to varying degrees. Contextual explanations drew on, for example, the role of doctors or family history in alerting people to a potential problem. These suggest both a different sense of risk consciousness, which may be prompted or contextual, and a less autonomous kind of consumer who is connected to others through a set of family and other relationships. Non-agential explanations, for example, where people attributed their consumption to others or to habit, appeal neither to the rationality, the health consciousness nor the autonomy of the actual consumer. The analysis helps to reinforce the potentially contextual or fluctuating nature of risk consciousness, and the relational and non-instrumental aspects of daily practices.Functional Food; Ordinary Consumption; Phytosterol; Cholesterol; Consumer Subject; Agency; Reflexivity; Food Practices; Non-Instrumental Conduct

Everyday curation? Attending to data, records and record keeping in the practices of self-monitoring

This paper is concerned with everyday data practices, considering how people record data produced through self-monitoring. The analysis unpacks the relationships between taking a measure, and making and reviewing records. The paper is based on an interview study with people who monitor their blood pressure and/or body mass index/weight. Animated by discussions of ‘data power’ which are, in part, predicated on the flow and aggregation of data, we aim to extend important work concerning the everyday constitution of digital data. In the paper, we adopt and develop the idea of curation as a theory of attention. We introduce the idea of discerning work to characterise the skilful judgements people make about which readings they record, how readings are presented, and about the records they retain and those they discard. We suggest self-monitoring produces partial data, both in the sense that it embodies these judgements, and also because monitoring might be conducted intermittently. We also extend previous analyses by exploring the broad set of materials, digital and analogue, networked and not networked, involved in record keeping to consider the different ways these contributed to regulating attention to self-monitoring. By paying attention to which data is recorded and the occasions when data is not recorded, as well as the ways data is recorded, the research provides specificity to the different ways in which self-monitoring data may or may not flow or contribute to big data sets. We argue that ultimately our analysis contributes to nuancing our understanding of ‘data power’

Navigating standards, encouraging interconnections: infrastructuring digital health platforms

Apps, websites and networked devices now offer to help consumers produce, access and share health knowledge, precipitating social scientific concern over the consequences of these so-called digital health platforms. This paper makes a novel contribution to this literature, taking up a recent call from Plantin et al. to adopt an infrastructural lens in exploring platforms. It argues, through empirical analysis of digital health platforms of different sizes, ages and nationalities, that this conceptual tool is necessary to surface the work entailed in creating and sustaining digital health platforms. Additionally, we suggest that the social scientific literature on platforms–and initial efforts to explore their infrastructural qualities–frequently focus too strongly on the dominant technology companies. Instead, we emphasise the value of drawing emergent companies’ platforms into empirical purview through returning to some of the infrastructures literature that informs Plantin et al.–particularly Susan Leigh Star and colleagues. We demonstrate empirically the importance of looking at standards as part of infrastructure building, and the broader set of interconnections between different actors and materials within an infrastructure. In doing so, we demonstrate the value of an infrastructural lens for understanding the density of interconnections that characterise digital health and propose some orientating questions for further enquiry into the infrastructural qualities of platforms

Patient and Professional Constructions of Familial Hypercholesterolaemia and Heart Disease: Testing the Limits of the Geneticisation Thesis

This thesis provides an empirical investigation of the geneticisation thesis. Geneticisation is one of the most prominent critiques of the social and cultural implications of developments in genetics. It incorporates a set of claims and expectations about the way genetic knowledge and technologies are transforming or will transform ideas about health and illness, and health care practices. This research aims to explore the empirical basis of these claims, by looking at the place of genetic discourses and practices in one specific area. The thesis focuses on familial hypercholesterolaemia (FH), a treatable hereditary cholesterol condition associated with high rates of coronary heart disease (CHD). It asks how much and in what ways patients with FH and professionals involved with the condition construct FH and CHD as genetic conditions. The thesis draws on three main areas of data - biomedical literature concerning CHD and FH; ethnographic work concerning the activities of HEART UK, the main UK health charity involved with inherited lipid disorders and cholesterol; and interviews with patients with FH and with staff and members of HEART UK. The analysis suggests that FH is not understood or managed within a strong genetic frame, and that neither professionals involved in HEART UK, nor patients with FH, provided or contributed to radically new or geneticised accounts of CHD. In short, the research suggests that geneticisation overstates the transformatory potential of genetics, and that factors such as the availability of effective therapeutics, the sites where care takes place, the disciplines involved, and existing lay and professional models of disease are important for the construction of a particular field. Furthermore, in arguing that FH is not associated with a strong specific disease identity or community, the analysis questions the notion of biosociality, suggesting that is may be less relevant to some biological states or conditions than to others

Proposal and design of airy-based rocket pulses for invariant propagation in lossy dispersive media

A novel kind of Airy-based pulse with an invariant propagation in lossy dispersive media is proposed. The basic principle is based on an optical energy trade-off between different parts of the pulse caused by the chromatic dispersion, which is used to compensate the attenuation losses of the propagation medium. Although the ideal concept of the proposed pulses implies infinite pulse energy, the numerical simulations show that practical finite energy pulses can be designed to obtain a partially invariant propagation over a finite distance of propagation

The Persistence of Cool Galactic Winds in High Stellar Mass Galaxies Between z~1.4 and ~1

We present an analysis of the MgII 2796, 2803 and FeII 2586, 2600 absorption line profiles in coadded spectra of 468 galaxies at 0.7 < z < 1.5. The galaxy sample, drawn from the Team Keck Treasury Redshift Survey of the GOODS-N field, has a range in stellar mass (M_*) comparable to that of the sample at z~1.4 analyzed in a similar manner by Weiner et al. (2009; W09), but extends to lower redshifts and has specific star formation rates which are lower by ~0.6 dex. We identify outflows of cool gas from the Doppler shift of the MgII absorption lines and find that the equivalent width (EW) of absorption due to outflowing gas increases on average with M_* and star formation rate (SFR). We attribute the large EWs measured in spectra of the more massive, higher-SFR galaxies to optically thick absorbing clouds having large velocity widths. The outflows have hydrogen column densities N(H) > 10^19.3 cm^-2, and extend to velocities of ~500 km/s. While galaxies with SFR > 10 Msun/yr host strong outflows in both this and the W09 sample, we do not detect outflows in lower-SFR (i.e., log M_*/Msun < 10.5) galaxies at lower redshifts. Using a simple galaxy evolution model which assumes exponentially declining SFRs, we infer that strong outflows persist in galaxies with log M_*/Msun > 10.5 as they age between z=1.4 and z~1, presumably because of their high absolute SFRs. Finally, using high resolution HST/ACS imaging in tandem with our spectral analysis, we find evidence for a weak trend (at 1 sigma significance) of increasing outflow absorption strength with increasing galaxy SFR surface density.Comment: Submitted to ApJ. 25 pages, 19 figures, Figure 2 reduced in resolution. Uses emulateapj forma

Low-ionization Line Emission from Starburst Galaxies: A New Probe of Galactic-Scale Outflows

We study the kinematically narrow, low-ionization line emission from a bright, starburst galaxy at z = 0.69 using slit spectroscopy obtained with Keck/LRIS. The spectrum reveals strong absorption in MgII and FeII resonance transitions with Doppler shifts of -200 to -300 km/s, indicating a cool gas outflow. Emission in MgII near and redward of systemic velocity, in concert with the observed absorption, yields a P Cygni-like line profile similar to those observed in the Ly alpha transition in Lyman Break Galaxies. Further, the MgII emission is spatially resolved, and extends significantly beyond the emission from stars and HII regions within the galaxy. Assuming the emission has a simple, symmetric surface brightness profile, we find that the gas extends to distances > ~7 kpc. We also detect several narrow FeII* fine-structure lines in emission near the systemic velocity, arising from energy levels which are radiatively excited directly from the ground state. We suggest that the MgII and FeII* emission is generated by photon scattering in the observed outflow, and emphasize that this emission is a generic prediction of outflows. These observations provide the first direct constraints on the minimum spatial extent and morphology of the wind from a distant galaxy. Estimates of these parameters are crucial for understanding the impact of outflows in driving galaxy evolution.Comment: Submitted to ApJL. 6 pages, 4 figures. Uses emulateapj forma

New practices for new publics: theories of social practice and the voluntary and community sector

The book relates to a seminar series ‘New Practices for NewPublics', which ran between November 2015 and October 2017 (see http://blogs.brighton.ac.uk/newpracticesfornewpublics/). Both the book and the seminars were funded by grant ES/N009398/1 from the Economic and Social Research Council

The drugs don't sell: DIY heart health and the over-the-counter statin experience

This paper draws on a study of over-the-counter statins to provide a critical account of the figure of the ‘pharmaceutical consumer’ as a key actor in the pharmaceuticalisation literature. A low dose statin, promising to reduce cardiovascular risk, was reclassified to allow sale in pharmacies in the UK in 2004. We analysed professional and policy debates about the new product, promotional and sales information, and interviews with consumers and potential consumers conducted between 2008 and 2011, to consider the different consumer identities invoked by these diverse actors. While policymakers constructed an image of ‘the citizen-consumer’ who would take responsibility for heart health through exercising the choice to purchase a drug that was effectively rationed on the NHS and medical professionals raised concerns about ‘a flawed consumer’ who was likely to misuse the product, both these groups assumed that there would be a market for the drug. By contrast, those who bought the product or potentially fell within its target market might appear as ‘health consumers’, seeking out and paying for different food and lifestyle products and services, including those targeting high cholesterol. However, they were reluctant ‘pharmaceutical consumers’ who either preferred to take medication on the advice of a doctor, or sought to minimize medicine use. In comparison to previous studies, our analysis builds understanding of individual consumers in a market, rather than collective action for access to drugs (or, less commonly, compensation for adverse effects). Where some theories of pharmaceuticalisation have presented consumers as creating pressure for expanding markets, our data suggests that sociologists should be cautious about assuming there will be demand for new pharmaceutical products, especially those aimed at prevention or asymptomatic conditions, even in burgeoning health markets

Healthcare practitioner views and experiences of patients self-monitoring blood pressure: vignette study

Background Home self-monitoring of blood pressure is widely used in primary care to assist in the diagnosis of hypertension, as well as to improve clinical outcomes and support adherence to medication. The National Institute for Health and Care Excellence (NICE) care pathways for hypertension recommend specific guidelines, although they lack detail on supporting patients to self-monitor. Aim To elicit primary care practitioners’ experiences of managing patients’ home blood pressure self-monitoring, across surgeries located in different socioeconomic areas. Design & setting A qualitative focus group study was conducted with a total of 21 primary care professionals. Method Participants were GPs and practice nurses (PNs), purposively recruited from surgeries in areas of low and high deprivation, according to the English indices of multiple deprivation. Six vignettes were developed featuring data from interviews with people who self-monitor and these were used in five focus groups. Results were thematically analysed. Results Themes derived in the thematic analysis largely reflected topics covered by the vignettes. These included: advice on purchase of a device; supporting home monitoring; mitigating patient anxiety experienced as a result of home monitoring; valuing patients’ data; and effect of socioeconomic factors. Conclusion The work provides an account of methods used by primary care practitioners in the management of home blood pressure self-monitoring, where guidance may be lacking and primary care practitioners act on their own judgement. Findings complement recent policy documentation, which recognises the need to adopt new ways of working to empower patients (for example, additional support from healthcare assistants), but lacks detail on how this should be done