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Drawing on Foucault's conceptualisation of power, this paper examines public health as a distinctly modern regime of governance. An account of the historical regulation of drug use is traced in order to examine socio-historical shifts and lines of continuity in contemporary technologies of harm reduction. Using qualitative interview data, we examined practices of power in the context of contemporary drug use, including self-governance using techniques of monitoring, self-management and self-tracking. Participants' accounts revealed that they were encouraged to self-govern their drug use through a variety of reformist technologies that are embedded in harm-reduction programs. It is argued that participants' subjectivity is formed at the intersection of authoritative governance and self-governance, through ethical practices of the self which have emerged from disciplinary health practices, and incorporate the body as the site of power. We illustrate this by drawing a distinction between hygienist and sanitationist practices of public health. These governmental practices, which are embedded in public health programs, encourage people who use drugs to transform themselves into moral citizens, aligning their ethical practices with governing interests. [ABSTRACT FROM AUTHOR]

Aboriginal and Torres Strait Islander people are the Indigenous people of Australia. The prevalence and burden of chronic disease among them is significantly higher than that of non-Indigenous Australians. This paper describes the chronic illness experiences of 19 Aboriginal and Torres Strait Islander people living in urban areas in terms of their strategic representations of self. Participants in this study used techniques of revealing and concealing chronic illness. These strategies were employed in multiple arenas - among family, among broader community, and in specific spaces including health care services. They highlight tensions that arise through the intersection between the desire to preserve family and community life, and the ways in which the physical body manifests chronic illness. In this paper we bring together notions of time (drawing on Zimbardo's time perspectives theory) and biography (drawing on Bury's disrupted biography theory). Through an analysis of shifting boundaries we conduct an exploratory investigation of the ways in which urban Aboriginal and Torres Strait Islander people in this study weave together elements of both past and future perspectives to mobilise modes of self-representation and agency in their management of chronic illness. We then consider some options for primary health care. [ABSTRACT FROM AUTHOR]

Dealing with ethics in health economics on socio-philosophical grounds is not yet well established. This paper shows how a liaison between the system theory of Luhmann and the philosophy of Taylor can be used to analyze and justify the incorporation of ethical considerations into health economics. One rationale for the incorporation of ethical consideration into health economics is the deficiencies in capturing all relevant needs of health system participants with common (welfare) economics. A second reason why health economics should account for ethical values is the fact that its decisions are already based on implicit value judgments. The impact of our approach is exemplified by the concept of 'quality adjusted life years' (QALYs). [ABSTRACT FROM AUTHOR]

This paper discusses mediation in the patient–provider relationship arising from the introduction of digital technology for a specific form of monitoring: 'clinical self-tracking'. Focusing on the management of type 1 diabetes, a condition that requires significant self-management by patients, we describe how the actors negotiated a new ICT-mediated relationship in three hospital departments. The analysis followed a qualitative design and was carried out by interviewing patients, clinicians and technology developers and by analysing messages exchanged through the ICT tool. We first show how each department customised the system by drawing on already existing care practices, organisational goals and representations of the department's desired relationship with the patients. We then focus on patient–provider relationships, showing that, while the clinical self-tracking sometimes followed the path desired by the providers, at other times, it developed in unexpected ways. We distinguish among three emerging categories of self-tracking: self-tracking for remote management, self-tracking for e-learning and self-tracking as boundary setting. The analysis reveals how the new patient–provider relationship arises from an open-ended process. Providers can push self-tracking practices but cannot steer them; and patients, through an unexpected use of the self-tracking technologies, are able to negotiate a desired relationship with providers. [ABSTRACT FROM AUTHOR]

The widespread availability of portable sensing devices has given rise to growing numbers of people voluntarily self-tracking their daily experiences through the medium of digital data. At the extreme end of this trend is the 'Quantified Self' movement. This collective uses sensor-enabled tech to extensively map aspects of their personal lives, before sharing procedural insights at community 'show and tell' events. A key aim of the group is to better understand imperceptible bodily processes, especially those influencing health states, as they are materialised through the datafied body. Despite the growth in those mobilising digital data for health management, little is known about the subjective meanings that are ascribed to self-monitoring practices. This paper explores how self-trackers conceptualise the data they generate, and how exteriorised bodily interiorities mediate impressions of embodiment. We suggest that the availability of self-tracked data has initiated interesting new relationships between data-subjects and their objectified bodies, dynamics that impact on how bodies are experienced and inhabited. We show how bodily intuition is being outsourced to, if not displaced by, the medium of 'unbodied' data. It is this objectivated facility that is increasingly used to orientate behavioural decisions as they relate to bodily maintenance. [ABSTRACT FROM AUTHOR]

The success of 'ageing-in-place' aged care policy in Australia relies heavily on the unpaid work of informal carers. While there is a wealth of research regarding informal carers more generally, we know relatively little about the experiences of the 'sandwich generation': Adult children (mainly daughters) who provide care for a parent while often juggling paid work and the care of their own children or grandchildren. In this paper I undertake a critical analysis of 'ageing-in-place' policy through the lens of 'sandwich generation' carers of people with dementia. Drawing from a composite case study, I argue that these carers are located at the interstices of powerful discourses such as 'individualisation' and 'care' and explore how the everyday practice of care is negotiated within these spaces. Inhabiting these spaces can be costly for carers and we need to consider how policies can better support intergenerational carers if 'ageing-in-place' is to be sustainable. [ABSTRACT FROM AUTHOR]

This paper considers how 'health behaviours' are imagined and practised in contemporary society, considering the combination of commercial products such as over the counter (OTC) statins and functional foods with more established 'healthy behaviours' in everyday life. Using data from users of low dose statins licensed for OTC sale in the UK and functional foods, we consider policy fears that such products would dilute efforts at healthy living. In line with sociological literature, we encountered resistance to pill-taking and accounts of health behaviour that show this to be a complex category that may involve functional or mundane foods, and supplements, may be highly targeted at heart health, or more defuse goals, or involve a degree of vagueness as to what is being used and why. Thinking about these practices as a form of 'DIY' provides a useful supplement to sociological interest in lay rationality, drawing attention to the objects rather than knowledges enrolled, and the provisional nature of health practices. [ABSTRACT FROM AUTHOR]

Much of the medical literature on patient compliance explores why patients fail to follow practitioners' instructions. This paper explores perspectives on 'compliance' expressed in online discussion groups for kidney patients. Discourse analysis was used to investigate how contributors conceptualise knowledge and the role of the renal patient. In the discussion groups, patients were sometimes seen to have better understanding of the details of their illness than some practitioners, a focus born of inhabiting their situation and therefore having more at stake. Some patients set themselves the task of supervising their own care, double checking the work of practitioners. This did not threaten biomedical knowledge, but these counter-discourses challenge professional boundaries by making it the prerogative of patients to obtain biomedical knowledge. I explore issues of surveillance and frustration, and the potential usefulness of patients' overseeing their own safety, while flagging the potential plight of less 'empowered' or motivated patients. [ABSTRACT FROM AUTHOR]

Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men's health, with men tending to be seen as largely 'irresponsible' towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting 'irresponsibly' was what defined participants as 'real men'. The implications of these findings for men's health policy are discussed with specific reference to the recent publication of Ireland's National Men's Health Policy. [ABSTRACT FROM AUTHOR]

Over the past decade, consumers in Australia and elsewhere have increasingly been confronted with a fast growing number of health food products. This profusion of health foods is accompanied by a proliferation in popular culture of professional nutritional advice on 'what is good to eat'. The genre of lifestyle magazines is one popular medium via which healthy eating practices and health foods are frequently reported. In this paper we use a visual discourse analysis of food-related editorial and advertorial content sourced from the long running and popular The Australian Women's Weekly to investigate how lifestyle magazines have been one important locus for constituting health conscious consumers. Taking up a Foucauldian governmentality perspective we trace how this active, responsible conceptualisation of the consumer, which we refer to as 'healthy food consumer', has increased in prevalence in the pages of The Australian Women's Weekly over time. Based on our analysis we suggest that the editorial and advertorial content offers models of conduct to individuals about what possible preventative activities in which to engage, and plays an important role in shaping how we think about taking care of our health through eating. [ABSTRACT FROM AUTHOR]

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Although issues of health have been thoroughly analysed in the field of migration studies, there are still very few studies that seek to understand the reproductive health of women in migratory processes. This article analyses the reproductive health of Bolivian migrant women living in the city of Córdoba, Argentina, through an analysis focused on the community assets that migrants deploy in the health-disease-care process within restrictive contexts of access to the health system. The research consisted of an exploratory study using in-depth interviews with Bolivian migrant women and health professionals through the implementation of semi-structured guidelines. The work shows that, in an environment characterised by a health system that acts to exclude, migrant women develop a series of rational strategies where they draw on community assets embodied in forms of selfcare of the body and in community networks. Based on a process of reframing memories related to health practices in the Andean world, these women incorporate these assets and more easily confront the obstacles that they must overcome as migrants in different stages of their reproductive health. [ABSTRACT FROM AUTHOR]

In this article we approach socioeconomic inequities in cancer by examining a particular dimension of health care: how health services attending patients with cancer set priorities for their daily activities. By using qualitative ethnographic data, we explore logics underlying how practitioners make priority-setting decisions regarding cancer prevention and care. We found four main types of accounts: accounts based on macro social inequalities, accounts based on patients' social and cultural features, accounts based on characteristics of health services, and accounts based on personal voluntarism. These blurred logics shape the everyday decisions which have an impact not only on the quality of health care in general but on the increasing socioeconomic inequities in cancer care attention. [ABSTRACT FROM AUTHOR]

In this article, we review critical research on mobile and wearable health technologies focused on the promotion of 'healthy lifestyles'. We begin by discussing key governmental and policy interests which indicate a shift towards greater digital integration in health care. Subsequently, we review relevant research literature, which highlights concerns about inclusion, social justice, and ownership of mobile health data, which we argue, provoke a series of key sociological questions that are in need of additional investigation. We examine the expansion of what counts as health data, as a basis for advocating the need for greater research into this area. Finally, we consider how digital devices raise questions about the reconfiguration of relationships, behaviours, and concepts of individuality. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented that discusses articles published on this issue including the one on fitness tracking through a Fitbit device, another on usage of health and fitness applications among English teenage girls, and the one on stress and recovery monitoring software.

In this article, we provide an account of Fitbit, a wearable sensor device, using two complementary analytical approaches: auto-ethnography and media analysis. Drawing on the concept of biopedagogy, which describes the processes of learning and training bodies how to live, we focus on how users learn to self-care with wearable technologies through a series of micropractices that involve processes of mediation and the sharing of their own data via social networking. Our discussion is oriented towards four areas of analysis: data subjectivity and sociality; making meaning; time and productivity and brand identity. We articulate how these micropractices of knowing one's body regulate the contemporary 'fit' and healthy subject, and mediate expertise about health, behaviour and data subjectivity. [ABSTRACT FROM AUTHOR]

Living kidney donation is an alternative treatment option for end-stage renal failure. Prospective donors are protected from risk by counselling and assessment processes, to ensure they are fully informed about all the stages of donation. Drawing on in-depth interviews with 25 living kidney donors from across New Zealand, this article discusses donors' experience of the pre-donation screening process, donation workup coordination, psychological preparation, and post-operative follow-up care and support. In particular, the article examines donor perceptions of the informed consent process. The findings indicate that donors' experience of the consent process may be at odds with the New Zealand Code of Health and Disability Services Consumers' Rights 1996. Instead of a primary healthcare focus on the threshold elements of informed consent, this study indicates that more effort should be made to adequately inform donors and to clearly spell out each stage of the donation process to better meet donors' needs. [ABSTRACT FROM AUTHOR]

Whilst 'biographical disruption' remains important for explaining how people rebuild biography following the onset of chronic illness, it does not self-evidently explain the problem of managing a fluctuating chronic condition such as non-specific low back pain. Chronic illness rarely leads to long-term improvement; the trajectory is not always linear, and sudden or gradual improvements alongside deterioration are commonly experienced. In the case of low back pain, self-management often involves utilisation of non-pharmaceutical approaches, personal resources for accommodating pain and disability, as well as managing symptoms with clinical treatments to relieve pain. Such a multifaceted approach -- not only concerned with the reduction of symptoms -- shifts focus beyond the 'disease' state and a single point of disruption, drawing attention to the use of 'health maintenance actions' to facilitate a proactive response to illness management. We propose this new approach as an alternative way of understanding the experience of patients with fluctuating health conditions such as low back pain. [ABSTRACT FROM AUTHOR]

Book prescription schemes and healthy reading schemes are public mental health initiatives that are inspired by the bibliotherapeutic principle of 'the guided use of reading, always with a therapeutic outcome in mind' (Katz & Watz, 1992). These initiatives were originally developed in the UK as an example of care in the community for the treatment of mild to moderate mental health problems. This involves the creation of a collection of self-help books in a local library which members of the public can access free of charge to help with their recovery from mental illness. Ireland's first Book Prescription Scheme was established in Dublin City in 2007. This article presents a critical assessment of the contribution that these reading schemes offer the treatment of mental illness in Ireland. While advocates commend this new service, a critical discourse analysis of Irish self-help reading schemes reveals that offering guided reading for the treatment of mental illness provides an individualistic and neo-liberal construction of mental illness and well-being. [ABSTRACT FROM AUTHOR]

I give an account of disquieting experiences in relation to my treatment and those with chronic illness in the acute system during my 5 years' experience as an informal caregiver. People with chronic illness (and their caregivers), particularly stroke survivors face a biased, frustrating and even dangerous acute care hospital system where they are second class. Well-being and stability from rehabilitation and self-management can be undermined. Dow and McDonald's (2007) concept: 'disenfranchised care contractors' within early discharge and 'hospital in the home' programs is generalised more broadly. The studies that initiated Hospital at Home programs are scrutinised. The Australian medical system relies on informal carers in a fundamental way but still does not identify or acknowledge them despite the presence of laws such as the Carers Recognition Act (2005). A new concept argues informal caregivers 'do social bonds' at a deep level, weaving the social fabric into a denser structure. But as part of the private world, the formal system treats them routinely with disrespect and they can be manipulated to obtain their participation in early discharge programs and long term care. [ABSTRACT FROM AUTHOR]