How Nurses Come to Race: Racialization in Public Health Breastfeeding Promotion.

This research study shows how race becomes ascribed through nursing theory and day-to-day workplace socialization processes. We show how public health nurses supporting and promoting breastfeeding for new mothers learn about and reproduce racialized stereotypes, which shape the care they provide. Even when nurses attempt to actively resist racialized stereotypes, most participate in essentialized nursing practice by using racialized institutional practices. Nursing theory needs to expand to help the nurse navigate and understand both the nurses' and client's local histories as well as individual-to-systems level constraints and supports that may impede, or promote, a mother's ability to breastfeed.

Cell Phones ≠ Self and Other Problems with Big Data Detection and Containment during Epidemics.

Evidence from Sierra Leone reveals the significant limitations of big data in disease detection and containment efforts. Early in the 2014-2016 Ebola epidemic in West Africa, media heralded HealthMap's ability to detect the outbreak from newsfeeds. Later, big data-specifically, call detail record data collected from millions of cell phones-was hyped as useful for stopping the disease by tracking contagious people. It did not work. In this article, I trace the causes of big data's containment failures. During epidemics, big data experiments can have opportunity costs: namely, forestalling urgent response. Finally, what counts as data during epidemics must include that coming from anthropological technologies because they are so useful for detection and containment.

Global health indicators and maternal health futures: The case of Intrauterine Growth Restriction.

Public health indicators generally operate in the world as credible, apolitical and authoritative. But indicators are less stable than they appear. Clinical critiques of Intrauterine Growth Restriction (IUGR) criteria have been forthcoming for decades. This article, though, takes up the measuring and calculation gradients of IUGR in the ultrasound machine itself, including the software algorithms that identify IUGR. One hospital where research was conducted incorrectly predicted pathological birth outcomes 14 of 14 times. We are at a historical moment when the global use of prenatal diagnostic ultrasound for the express purpose of assessing IUGR is set to escalate. Medical imaging device corporations like Siemens, Toshiba, General Electric and Phillips are quite literally banking on it, and new forms of ultrasound technology and diagnostic software are increasingly available on smartphones, tablets and laptops. Clinical guidelines for IUGR--assumed to be authoritative and evidence-based--are evolving right along with the installation throughout the world of the technology capable of diagnosing it. Maternal malnutrition remains the single strongest predictive factor for IUGR, regardless of the technological investments currently amassing to identify the indicator, which is cause for a reassessment of priority spending and investment.

Global health business: the production and performativity of statistics in Sierra Leone and Germany.

The global push for health statistics and electronic digital health information systems is about more than tracking health incidence and prevalence. It is also experienced on the ground as means to develop and maintain particular norms of health business, knowledge, and decision- and profit-making that are not innocent. Statistics make possible audit and accountability logics that undergird the management of health at a distance and that are increasingly necessary to the business of health. Health statistics are inextricable from their social milieus, yet as business artifacts they operate as if they are freely formed, objectively originated, and accurate. This article explicates health statistics as cultural forms and shows how they have been produced and performed in two very different countries: Sierra Leone and Germany. In both familiar and surprising ways, this article shows how statistics and their pursuit organize and discipline human behavior, constitute subject positions, and reify existing relations of power.

Fetal views: histories and habits of looking at the fetus in Germany.

This article examines historical and ideological trajectories that have made looking at the fetus via ultrasound a normal part of being pregnant for many women around the world. How did looking into so unlit a bodily space as the uterus become so natural? So everyday? So habit-forming? The answers lie in the convergence over time of technological hardware with knowledge practices that moved from medical to public domains. Germany serves as a site for an interrogation of how learned ways of thinking about anatomy, the development of technologies that "look," a privileging of the visual in medical domains, and seeing as metaphor for truth about health reinforced and normalized prenatal ultrasound use.

Post-diagnostic abortion in Germany: reproduction gone awry, again?

Routine use of prenatal diagnostic technologies (PDTs) such as ultrasound and amniocentesis result in the detection of a small percentage of fetal anomalies. For those women faced with the diagnosis of fetal disability, a decision must be made to continue or terminate the pregnancy. When the diagnosis is merely hypothetical, the discursive specter of post-diagnostic abortion is shaped by social and historical contexts in which interested discourses (regional, political, ethical, and religious) weigh in with varying degrees of authority and influence. However, when the diagnosis is actual, in this sample population of women, an estimated minimum of 90% opt to terminate their pregnancies. Data collected at two German hospitals-one in former East Germany, one in former West Germany-illuminate rates of PDT use and provide data with which to discuss the specter of post-diagnostic abortion in relation to mainstream medical discourses, Germany's divided history, abortion politics, feminism, disability activism, and religion. These data demonstrate how reproductive discourses are shaped by ideological and historical contingencies, even when women's ultimate reproductive decisions are not.