A long-standing debate in agrifood sociological work explores how consumer attitudes and behaviours regarding food consumption contribute to healthy food systems. This debate is particularly evident in the study of Alternative Local Food Systems (ALFS), where the potential of 'ethical consumption' to reorient food production-consumption relationships and improve human and ecological health, including food security, remains a subject of ongoing inquiry. Individual consumption from systems of alternative forms of food production (organics, agroecology) and distribution (cooperatives, food hubs) reflect changing consumer values and practices towards sustainable diets. This paper contributes to health sociology by taking a theoretical approach to this debate and drawing on scholarship exploring the relationship between ethical consumption and systems transformation. By examining how different consumption theories (ethical, sustainable, green and political) grapple with the individual-collective dilemma, it offers insights into the determinants of health by demonstrating how ethical consumption, ranging from individual values to collective activism, can influence access to heathy food and ultimately shape health outcomes. It also examines ALFS' contributions to promote collective modes of consumption. This sheds light on how collective agency might prompt deeper food democratic shifts beyond individual consumption, potentially supporting healthy and sustainable diets.

One understudied aspect of the COVID-19 pandemic is the opportunity it provided for nurse practitioners (NPs) to practice autonomously and therefore professionalise. We undertake a quantitative analysis to understand how the pandemic impacted scope of practice laws governing NPs in the United States. We find that NPs were newly granted at least temporary autonomy in 22 US states, and that those policy changes were associated with increasing COVID-19 caseloads. We construct an analytic narrative that situates the COVID-19 pandemic in the larger context of NP professionalisation under physician dominance. We argue that NPs professionalised by achieving small wins of establishing presence, building legitimacy, forming coalitions, and gaining ubiquity between legislation and a pandemic. We use the case of NP professionalisation to build the concept of a professionalisation opportunity structure, which we define as a framework of conditions available for an occupational group to gain autonomy and which consists of periods of small wins punctuated by field-level changes. A professionalisation opportunity structure provides an explanation of professionalisation that transcends intra-occupational dynamics and could be applied to other healthcare occupations seeking to professionalise under physician dominance.

Healthism, a neoliberal ideology that frames health as an individual responsibility and moral duty, inherently operates as a blame-the-victim framework, attributing health outcomes primarily to personal choices and behaviours. This qualitative study critically examines healthism's influence on community-based hypertension care in China, particularly its reinforcement of individualised blame and patient distress. Based on semi-structured interviews with 18 community health professionals and 17 hypertensive patients in Shenzhen, the study reveals that while self-care is promoted as essential to hypertension management, it often fosters feelings of inadequacy and social isolation, particularly among patients struggling to meet the expectations set by healthcare providers. Participants also report emotional distress exacerbated by socio-economic challenges that remain unaddressed within the healthcare system. Moreover, the individualisation of health responsibility erodes trust between patients and providers, as patients internalise failure when unable to adhere to prescribed lifestyle modifications. This study critiques the reductive association between patient autonomy and improved health outcomes, advocating for a more holistic approach to hypertension care that acknowledges broader social determinants of health and prioritises structural support for patient well-being.

In the UK, a range of everyday activities are being re-framed as interventions to promote public mental health. Drivers of this include the rising burden of mental ill-health and constrained funding for community-based arts and educational provision, in the context of austerity. A consequent interest in evaluating the health and wellbeing benefits of 'non-pharmacological' interventions has brought into play some diverse logics of effect. Taking Creative Bibliotherapy - reading and discussing fiction for therapeutic ends - as a case study, we explore what happens when these logics intersect. Our analysis draws on qualitative data on how reading is understood as therapy by those involved in one area of the UK. In accounting for what it was and how it worked, these actors negotiated a series of tensions in advocating for bibliotherapy. These included: reading is inherently worthy, but has instrumental benefits; reading is universally therapeutic, yet implicated in signalling social distinction; Bibliotherapy demands a widened vision of the 'therapeutic', yet resists medicalisation. These ambiguities, we suggest, means that Creative Bibliotherapy troubles biomedicine, in foregrounding its limitations for addressing contemporary public mental health crises, and the paucity of its dominant models of therapeutic effect.

The COVID-19 pandemic has raised probing questions about the politics that underly health governance. This article engages with recent sociological and political analyses in this regard and offers a reconsideration of what the pandemic represents for global health governance: a moment of reconfiguration rather than continuity or fundamental change. Drawing on Paul Rabinow's notion of 'the contemporary' as a mode of analysis, we conceptualise global health governance as a 'contemporary configuration' and analyse publicly available data from sources documenting the international response to COVID-19. We identify the appearance of a specific kind of problematisation of solidarity in the light of perceived disarray and fragmentation in global health governance. A perception related to the dynamics that evolved in the international political system during the emergency. Further, we discern processes of remediation in global health governance that unfolded around that problematisation of solidarity. We argue that global health governance, as it emerged in the COVID-19 emergency, should not simply be understood as bounded by the past nor as dramatically altered in the present. Instead, it had undergone a reconfiguration wherein solidarity may potentially become the crux of its politics.

This essay provides a critical overview of historical and contemporary conceptualisations of selfhood in dementia. We explore the intersections of psychological and sociological research, as well as care practices, in dementia scholarship and how these have evolved in the years leading to and proceeding the start of the twenty-first century. Focusing on historical discourses of dementia and the metaphor of dementia as a 'living death', this essay maps the development of prominent conceptualisations of dementia in western cultures, from their roots in Cartesian philosophy to modernist values and existential anxieties. We firstly explore historical notions of selfhood in people living with dementia and the presumed erosion of the self that culminates in a so-called living death. Then, we discuss the radical shift in attitudes that arose around the start of the twenty-first century towards perseverance of selfhood in dementia and person-centred care. We finally consider whether our current understanding of selfhood in dementia could benefit from a posthuman approach, which requires a radical shift towards a more relational, multiple, and ultimately affirmative ways of caring for dementia.

The health implications of prolonged wildfire smoke exposure - such as that seen during the 2019-2020 Australian bushfires - are a major concern in public health, not only in Australia but in many fire-prone areas globally. One group identified as potentially more susceptible to smoke exposure than the general population are pregnant women. Based on a study of how pregnant women and parents with newborn babies experienced the bushfire smoke event in Canberra and the NSW southeast coast, the paper examines how the placenta was figured across two domains during this time. The first domain considers how the placenta became prominent in the context of public and medical concerns about the immediate and long-term impacts of the bushfire smoke, focusing on pregnant women as a 'vulnerable' population. Secondly, we explore how the placenta figured in the narratives of women in our study: how they imagined their bodies responding to smoke exposure and how the smoke made more visible the interiority of their bodies. We argue that these narratives illustrate how environmental crises can reshape experiences of (pregnant) embodiment, imaginaries of future health, and our place in an increasingly uncertain world.

Sociologists are increasingly interested in exploring the role of time in relation to illness, disability, and care. However, the question of how individuals experience and navigate the temporal dimensions of sleep in their everyday and everynight lives requires further empirical research. The present study addresses this question using in-depth semi-structured interviews with 66 employed midlife Israelis from diverse sociodemographic backgrounds. The findings indicate that sleep experiences are shaped by a complex interplay of biological, social, and seasonal rhythms. Sleep patterns recur nightly, weekly, seasonally, and following major life events and transitions, combining to create what I call - the evolving rhythmic patterns and disruptions that characterise the lived dynamics of sleep throughout a person's lifecourse. The study underscores the concept of polyrhythmia - multiple rhythms - in everyday and everynight life and shows how various rhythms can either harmonise or clash, often co-producing each other. The study explores individuals' efforts to negotiate these rhythms, illustrating how all these processes profoundly impact human experiences, social relationships, and health.

While the discourse on care is largely pessimistic, brilliance happens, demonstrated by instances when care exceeded expectation. To advance brilliant care scholarship, this article asks, what are the domains that enable it? Through a reflexive analysis of ten publications on brilliant care, four domains were constructed and justified - namely: a relational orientation to care; attentive engagement; working with and beyond the technical aspects of healthcare; and shared responsibility. This article concludes with an invitation to those who receive, deliver, manage, develop policies that are relevant to, or conduct research on health service management - namely, to consider how these domains can be improved and how they can be systematised and translated into policy and practice, without compromising their dynamic quality.

We draw on the concept of 'biopedagogies' to explore the effects of 'living skills' training for young people in alcohol and other drug (AOD) treatment; that is, the knowledge and skill needed for everyday living to manage work, relationships and self-care. In-depth interviews conducted longitudinally with 38 young people explored how these pedagogies regulated participants' everyday practices and also produced unanticipated outcomes. We found that 'pedagogies for living well' governed in predictable ways by setting up norms promoting self-management and affording subjectivities as 'healthy' rather than 'addicted' and responsible rather than compulsive. Importantly, there were transformative effects whereby pedagogies for living well, especially the skill-building around paid work, produced new orientations to the future in which young people felt that reduction and cessation of substance use was achievable and that they had promising futures if the correct conditions were present. Thus, pedagogies for living well achieved their goal - to reduce substance use - but not through rationalist logics that assume young people straightforwardly take up information about 'living skills' and enact desired behaviours. Instead, pedagogies reap benefits for young people when they embrace a understanding of substance use as a practice that emerges from the social conditions of young people's lives.

This article delves into the underexplored relationship between lay expertise and temporality by analysing semi-structured interviews with parents who treat their autistic children using complementary and alternative medicine (CAM). The analysis indicates that time and temporalities play a significant role in how parents construct and enact their expertise. Faced with uncertainty, urgency, and inadequate support from medical and educational systems, parents assumed crucial responsibilities in managing their children's therapies. Over time, they acquired knowledge and skills, ultimately claiming expertise in caring for their children, making therapy decisions and administering treatments. Parents engaged in complex time work as they attempted to orchestrate everyday, developmental, therapeutic, and social rhythms, alternating their focus between future and present. They endeavoured to synchronise their children's rhythms with those of peers by using CAM therapies not yet adopted into conventional medicine, which they perceived as slow and outdated. This study contributes novel insights into autism care, temporalities of care, and the under-examined nexus between lay expertise and temporality.

In this paper, we explore negotiations around sexuality and gender diverse identities together with sexual practices, and the materialities of bodies, as they relate to the sampling and recruitment of LGBTQ+ participants in health social science research. The basis of our research note is a reflection on our experiences of undertaking a study on the social dimensions of antimicrobial resistance (AMR) in the context of sexually transmitted infections (STIs). We aimed to identify tensions and important considerations in the sampling and recruitment of LGBTQ+ populations in health and social science research. Recognising the fluidity and diversity of gender and sexuality, the multiple meanings attached to them, and the proliferation of gender and sexuality identifiers, we argue for the critical importance of reflexivity in curating a sampling frame, which is respectful of LGBTQ+ diversity. This contributes to the growing body of work that reflects on how to develop meaningful and informed approaches to do research with LGBTQ+ populations. We do this by complicating the often-linear presentation of sampling and recruitment processes within scholarly research.

While many sociologists have conceptualised medical and experiential modes of knowing health and illness, less attention has been given to the concept of empathetic knowledge. That is, knowledge derived from close association with others living with a particular condition. This article investigates empathetic modes of knowing among families marked by illness, drawing on 52 h of video recordings of support group sessions for children of parents with mental illness in Denmark and interviews with 11 participating children. Inspired by the sociology of empathy, the analysis shows that empathetic knowledge involves knowing illness from the outside (through observations of the ill person's body) and from the inside (through the affective impressions left on the next of kin's own body). This empathetic knowledge is relational, bodily and affective, and, together with other ways of knowing, it shapes everyday lives and projects imagined futures. The article demonstrates that the concept of empathetic knowledge can advance our sociological understandings of next of kin.

Multidisciplinary team meetings are part of the everyday working life of palliative care staff. Based on ethnographic material from community and hospital palliative care teams in England, this article examines these meetings as dynamic routines. Although intended to have a prescribed format to review deaths and collect standardised information to monitor service performance, in practice, the content and conduct of the meetings were fluid, reflecting how this structure did not always match the concerns held by the team. The meetings provided a means for the team to collectively enact and weigh up different values through distributing the care and responsibility for individual patients across the team; jointly 'feeling their way' to determine what care should be offered and in what form; and by caring for their own professional wellbeing in the context of metric-driven healthcare. We observed how staff experienced tensions in 'documenting care' because of a concern that this misrepresented what they felt were core aspects of their role. Whilst team meetings may be considered a formal, routine part of teamwork and care, we interpret them as a dynamic social practice during which palliative care teams continually question 'what really matters' and (re)make what palliative care practice should entail.

Comfort is a central aspect of palliative care, encompassing the management of pain and symptoms, as well as how people feel and experience care. Comfort has been argued to be especially tenuous or transient in palliative care, as a constantly shifting set of bodily sensations and relations are anticipated and cared for. In this article, drawing on in-depth interviews and photo elicitation, we explore the accounts of patients, family carers, staff and volunteers from a palliative care service in Australia, to understand how care is configured and facilitated through everyday gestures of comfort. We unpack how comfort (and comforting) is understood, sought, and done, to reveal how it is experienced as a set of social, relational, processual, and dynamic relations between bodies and environments. Our findings reveal how comfort for those nearing the end of life and those who care for them is brought about variously in the familiarity and reliability of things and surroundings, as well as through gestures of intimacy, recognition, and flexibility. We find that while predominantly considered as intentional and momentary, comfort has lasting effects. These lingering affective resonances, we argue, are key to recognising the diversity of what matters to people in palliative care.

People living with life-limiting illnesses often talk about their ideal experience of 'care' as one where the care itself is hidden. Situated in the sociological literature on places and materialities of palliative care, in this paper I examine the hiding of care in a small, non-clinical respite house in an Australian city. Care is hidden by the at-homeness that staff, guests and volunteers alike all do. Working with Oldenburg's notion of 'third places,' I show how in this illness context the separation between home, work and other places in the community can blur, with respite services 'standing in' for the family home, or acting as a 'homely' extension of the hospital. Such places meet diverse needs beyond pure sociability as in Oldenburg's original conceptualisation.

Benzodiazepines are a class of drug extensively used in palliative care. Their use has predominantly been studied within a biomedical framework. Our study instead focused on the sociocultural aspects of benzodiazepine practices. We aimed to explore clinicians, patients and family members' values, beliefs, knowledge and feelings regarding use of benzodiazepines, including in-situ clinical decision-making processes, affects and actions. Social theory understandings of affect, the body and of suffering provided the theoretical lens through which data were analysed. Analysis generated the following themes: (1) A special specialty; (2) The suffering body and the moral imperative to 'settle; (3) The liminal body - living and dying; and (4) Organizational realities. Use of benzodiazepines were largely governed by social and moral norms, cultural expectations and organizational realities as part of affective assemblages of care.

Integrating palliative care into the trajectories of patients with incurable cancer has been a priority for years. Yet, the intended outcomes of this integration remain elusive. Many patients with advanced cancer continue to receive so-called aggressive treatments in the end-of-life phase or miss out on specialised palliative care entirely. To examine this impasse in the Danish context, we employ the concept of to analyse policy documents and guidelines aimed at guiding professionals working with this patient group. The three identified scripts - cancer treatment, medical palliation and holistic palliative care - embody a distinct understanding of integration, contributing to the challenges of forging an integrated approach. We argue that the central role of the cancer treatment script in patient trajectories creates an obligatory passage point, influencing both the symbolic and practical enactment of integrated palliative care throughout these trajectories.

This study explored how people who use drugs (PWUD) experience and respond to stigma in biomedical chronic non-cancer pain management. Thematic analysis of in-depth interviews with PWUD ( = 26) who had sought care for chronic non-cancer pain in public hospitals in Uyo, Nigeria, drew on the idea of stigma as process of social reproduction and the concept of borderwork. Accounts framed stigma as a normalised feature of healthcare that emerged under different circumstances and operated to position chronic non-cancer pain patients who were PWUD as illegitimate subjects underserving of care. Stigma was widely seen as something to be expected, and was often tolerated by PWUD due to its ubiquity. However, they enacted borderwork marking-off stigma experiences that violated values of fairness and humaneness as well as those that spurned traditional gender norms. Participants responded to intolerable stigma through various acts of resistance, including dropping out of care. Stigma creates barriers to adequate pain management and establishes a context where basic care is accessed at the cost of fundamental human rights and dignity. Routine toleration of stigma helps to naturalise the phenomenon and render it invisible. Resistance to stigma provides a basis for interventions to address all forms of stigma in healthcare.