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Book ; Online: Chapter 7 Finding the global in the local : Constructing population in the search for disease genes

Sturdy, Steve

2020

Keywords	History of medicine ; Mathematics & science ; International institutions ; human genetic variation ; non-Western populations ; disease aetiology ; association studies ; population genomics
Size	1 electronic resource (29 pages)
Publisher	Manchester University Press
Publishing place	Manchester
Document type	Book ; Online
Note	English ; Open Access
HBZ-ID	HT021026994
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Framing utility: Regulatory reform and genetic tests in the USA, 1989-2000.

Sturdy, Steve

Social science & medicine (1982)

2020 Volume 304, Page(s) 112924

Abstract: Before about 1990, insofar as diagnostic and other medical tests were subject to regulatory oversight, it was chiefly to ensure that they met appropriate standards of analytic and clinical validity. Over the course of the 1990s, however, regulatory ... ...

Abstract	Before about 1990, insofar as diagnostic and other medical tests were subject to regulatory oversight, it was chiefly to ensure that they met appropriate standards of analytic and clinical validity. Over the course of the 1990s, however, regulatory reformers in the United States began to argue that genetic tests, specifically, should also be assessed to determine whether or not they actually benefit those undergoing testing-whether they possess "clinical utility", as they put it. The present paper asks why this shift in regulatory focus occurred specifically in relation to genetic tests, and why clinical utility became a key object of assessment. It answers these questions by situating concerns about genetic tests in the longer history of medical genetics. Looking back to the 1970s and medical geneticists' efforts to distance themselves from their earlier association with eugenics, it shows that they adopted a particular framing of the dangers of genetic testing which would inform their response to the proliferation of new genetic tests and the growth of commercial testing in the 1990s. In a series of policy committees convened over the course of that decade, medical geneticists called for regulatory measures to be implemented to ensure that genetic tests were only introduced into medical practice if they had been shown to be beneficial to those tested. The paper follows the deliberations of those committees to show in detail how geneticists worked within this framing to accommodate new technical capacities and regulatory opportunities. In the course of these deliberations, they adopted the idea of clinical utility to signify the need for evidence of benefit specifically to those tested. The paper concludes with some observations regarding how this framing of genetic tests relates to current understandings of "genetic exceptionalism" and to more recent articulations of clinical utility.
MeSH term(s)	Eugenics ; Genetic Testing ; Humans ; Organizations ; United States
Language	English
Publishing date	2020-03-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	4766-1
ISSN	1873-5347 ; 0037-7856 ; 0277-9536
ISSN (online)	1873-5347
ISSN	0037-7856 ; 0277-9536
DOI	10.1016/j.socscimed.2020.112924
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Article ; Online: Personalised Medicine and the Economy of Biotechnological Promise.

Sturdy, Steve

The New bioethics : a multidisciplinary journal of biotechnology and the body

2017 Volume 23, Issue 1, Page(s) 30–37

Abstract: Rather than seek to distinguish hype from legitimate promise, it may be more helpful to think about personalised medicine as embodying a promissory economy which serves both to mobilize resources for research and - partly at least - to determine the ends ...

Abstract	Rather than seek to distinguish hype from legitimate promise, it may be more helpful to think about personalised medicine as embodying a promissory economy which serves both to mobilize resources for research and - partly at least - to determine the ends to which that research is directed. Personalised medicine is a development of the larger promissory economy of medical biotechnology. As such, it systematically conflates public benefit with the pursuit of commercial and especially pharmaceutical interests. Consequently, research and development in personalised medicine tends to favour the production of expensive new treatments over unprofitable forms of prevention or more effective use of older therapies. A rebalancing of research priorities is needed to favour the pursuit of public benefit, even when it does not deliver private profits. This will in turn require sustained reflection, self-criticism and often self-denial on the part of public research funders and the scientists they support.
MeSH term(s)	Biotechnology ; Humans ; Precision Medicine ; Research/trends
Language	English
Publishing date	2017-05-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2727428-7
ISSN	2050-2885 ; 2050-2877
ISSN (online)	2050-2885
ISSN	2050-2877
DOI	10.1080/20502877.2017.1314892
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Article ; Online: Multidisciplinary perspectives on the regulation of diagnostic technologies.

Hogarth, Stuart / Miller, Fiona A / Sturdy, Steve

Social science & medicine (1982)

2022 Volume 304, Page(s) 115059

MeSH term(s)	Humans ; Interdisciplinary Studies ; Technology
Language	English
Publishing date	2022-06-14
Publishing country	England
Document type	Editorial
ZDB-ID	4766-1
ISSN	1873-5347 ; 0037-7856 ; 0277-9536
ISSN (online)	1873-5347
ISSN	0037-7856 ; 0277-9536
DOI	10.1016/j.socscimed.2022.115059
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Article ; Online: Remaking critical care: Place, body work and the materialities of care in the COVID intensive care unit.

Montgomery, Catherine M / Docherty, Annemarie B / Humphreys, Sally / McCulloch, Corrienne / Pattison, Natalie / Sturdy, Steve

Sociology of health & illness

2023 Volume 46, Issue 3, Page(s) 361–380

Abstract: In this article, we take forward sociological ways of knowing care-in-practice, in particular work in critical care. To do so, we analyse the experiences of staff working in critical care during the first wave of the COVID-19 pandemic in the UK. This ... ...

Abstract	In this article, we take forward sociological ways of knowing care-in-practice, in particular work in critical care. To do so, we analyse the experiences of staff working in critical care during the first wave of the COVID-19 pandemic in the UK. This moment of exception throws into sharp relief the ways in which work and place were reconfigured during conditions of pandemic surge, and shows how critical care depends at all times on the co-constitution of place, practices and relations. Our analysis draws on sociological and anthropological work on the material culture of health care and its sensory instantiations. Pursuing this through a study of the experiences of 40 staff across four intensive care units (ICUs) in 2020, we provide an empirical and theoretical elaboration of how place, body work and care are mutually co-constitutive. We argue that the ICU does not exist independently of the constant embodied work of care and place-making which iteratively constitute critical care as a total system of relations.
MeSH term(s)	Humans ; COVID-19 ; Pandemics ; Intensive Care Units ; Critical Care
Language	English
Publishing date	2023-09-13
Publishing country	England
Document type	Journal Article
ZDB-ID	795552-2
ISSN	1467-9566 ; 0141-9889
ISSN (online)	1467-9566
ISSN	0141-9889
DOI	10.1111/1467-9566.13708
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Article ; Online: How and why to use 'vulnerability': an interdisciplinary analysis of disease risk, indeterminacy and normality.

Ford, Andrea / De Togni, Giulia / Erikainen, Sonja / Filipe, Angela Marques / Pickersgill, Martyn / Sturdy, Steve / Swallow, Julia / Young, Ingrid

Medical humanities

2024 Volume 50, Issue 1, Page(s) 125–134

Abstract: In recent years, 'vulnerability' has been getting more traction in theoretical, professional and popular spaces as an alternative or complement to the concept of risk. As a group of science and technology studies scholars with different disciplinary ... ...

Abstract	In recent years, 'vulnerability' has been getting more traction in theoretical, professional and popular spaces as an alternative or complement to the concept of risk. As a group of science and technology studies scholars with different disciplinary orientations yet a shared concern with biomedicine, self and society, we investigate how vulnerability has become a salient and even dominant idiom for discussing disease and disease risk. We argue that this is at least partly due to an inherent indeterminacy in what 'vulnerability' means and does, both within and across different discourses. Through a review of feminist and disability theory, and a discussion of how vulnerability and disease both get recruited into a binary conceptualisation of normal versus abnormal, we argue that vulnerability's indeterminacy is, in fact, its strength, and that it should be used differently than risk. Using COVID-19 management in the UK as an illustration of the current ambivalence and ambiguity in how vulnerability versus risk is applied, we suggest that instead of being codified or quantified, as it has started to be in some biomedical and public health applications, vulnerability and its remedies should be determined in conjunction with affected communities and in ways that are polyvalent, flexible and nuanced. The concept of vulnerability encapsulates an important precept: we must recognise inequality as undesirable while not attempting to 'solve' it in deterministic ways. Rather than becoming fixed into labels, unidirectional causalities or top-down universalising metrics, vulnerability could be used to insist on relational, context-specific understandings of disease and disease risk-in line with contemporary social justice movements that require non-hierarchical and non-universal approaches to problems and solutions.
MeSH term(s)	Humans ; Concept Formation ; Social Justice ; Disabled Persons
Language	English
Publishing date	2024-02-22
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2018219-3
ISSN	1473-4265 ; 1468-215X
ISSN (online)	1473-4265
ISSN	1468-215X
DOI	10.1136/medhum-2023-012683
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Article ; Online: Domesticating models: On the contingency of Covid-19 modelling in UK media and policy.

Engelmann, Lukas / Montgomery, Catherine M / Sturdy, Steve / Moreno Lozano, Cristina

Social studies of science

2022 Volume 53, Issue 1, Page(s) 121–145

Abstract: Our article traces the representation of pandemic modelling in UK print media from the emergence of Covid-19 to the early stages of implementing the first UK-wide lockdown in late March 2020. Covid modelling, it is widely assumed, has shaped policy ... ...

Abstract	Our article traces the representation of pandemic modelling in UK print media from the emergence of Covid-19 to the early stages of implementing the first UK-wide lockdown in late March 2020. Covid modelling, it is widely assumed, has shaped policy decisions and public responses to the pandemic in unprecedented ways. We analyse how the UK print media has configured modelling as a significant evidence tool in the representation of the pandemic. Interrogating assumptions about infectious disease modelling, we ask why models became the trusted tool of choice for knowing and responding to the Covid pandemic in the UK. Our analysis has yielded four different periods in the evolution of intersecting policy and media frames. Initially, modellers, policymakers and media alike emphasized uncertainty about available data, and hence the speculative character of modelled projections, thus justifying a 'wait and see' approach to government intervention. With growing public pressure for government action, policy and media frames were adjusted to emphasize the importance of timing interventions for best effect, with modelling evidence mobilized to justify inaction. This gave way to a period of crisis, as the press increasingly questioned the reliability of the existing models and policies, leading modellers and policy makers to dramatically revise their projections. Finally, with the imposition of the first UK lockdown, policy and media frames were brought back into alignment with one another, in a process of domestication through which the language of modelling became a basic resource for the discussion of the epidemic. Our epistemological microhistory thus challenges general accounts of the impacts of pandemic modelling and instead emphasizes contingency and interpretative flexibility.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Reproducibility of Results ; Communicable Disease Control ; Health Policy ; Pandemics ; United Kingdom/epidemiology
Language	English
Publishing date	2022-10-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	1482712-8
ISSN	1460-3659 ; 0306-3127
ISSN (online)	1460-3659
ISSN	0306-3127
DOI	10.1177/03063127221126166
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Critical care work during COVID-19

Corrienne Mcculloch / Catherine M Montgomery / Steve Sturdy

BMJ Open, Vol 11, Iss

a qualitative study of staff experiences in the UK

2021 Volume 5

Abstract: Objective To understand National Health Service (NHS) staff experiences of working in critical care during the first wave of the COVID-19 pandemic in the UK.Design Qualitative study using semistructured telephone interviews and rapid analysis, ... ...

Abstract	Objective To understand National Health Service (NHS) staff experiences of working in critical care during the first wave of the COVID-19 pandemic in the UK.Design Qualitative study using semistructured telephone interviews and rapid analysis, interpreted using Baehr’s sociological lens of ‘communities of fate’.Participants Forty NHS staff working in critical care, including 21 nurses, 10 doctors and advanced critical care practitioners, 4 allied health professionals, 3 operating department practitioners and 2 ward clerks. Participants were interviewed between August and October 2020; we purposefully sought the experiences of trained and experienced critical care staff and those who were redeployed.Setting Four hospitals in the UK.Results COVID-19 presented staff with a situation of extreme stress, duress and social emergency, leading to a shared set of experiences which we have characterised as a community of fate. This involved not only fear and dread of working in critical care, but also a collective sense of duty and vocation. Caring for patients and families involved changes to usual ways of working, revolving around: reorganisation of space and personnel, personal protective equipment, lack of evidence for treating COVID-19, inability for families to be physically present, and the trauma of witnessing extreme patient acuity and death on a large scale. The stress and isolation of working in critical care during COVID-19 was mitigated by strong teamwork, camaraderie, pride and fulfilment.Conclusion COVID-19 has changed working practices in critical care and profoundly affected staff physically, mentally and emotionally. Attention needs to be paid to the social and organisational conditions in which individuals work, addressing both practical resourcing and the interpersonal dynamics of critical care provision.
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: So long, succor.

Sturdy, Steve

Technology and culture

2010 Volume 48, Issue 1, Page(s) 169–174

MeSH term(s)	Biomedical Technology ; Humans ; Knowledge ; Medicine ; Therapeutics ; Treatment Outcome ; Uncertainty
Language	English
Publishing date	2010-07-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2021131-4
ISSN	1097-3729 ; 0040-165X
ISSN (online)	1097-3729
ISSN	0040-165X
DOI	10.1353/tech.2007.0042
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Biotechnology and the transformation of vaccine innovation: The case of the hepatitis B vaccines 1968-2000.

Huzair, Farah / Sturdy, Steve

Studies in history and philosophy of biological and biomedical sciences

2017 Volume 64, Page(s) 11–21

Abstract: The approval, from 1986, of a series of recombinant hepatitis B vaccines was a landmark both in the growth of biotechnology and in the development of the vaccine innovation system. In this paper, we show how the early development of the hepatitis B ... ...

Abstract	The approval, from 1986, of a series of recombinant hepatitis B vaccines was a landmark both in the growth of biotechnology and in the development of the vaccine innovation system. In this paper, we show how the early development of the hepatitis B vaccines was shaped by a political and economic context that newly favoured commercialisation of academic research, including the appropriation and management of intellectual property; we elucidate the contingent interests and motivations that led new biotechnology companies and established pharmaceutical businesses to invest in developing recombinant vaccines specifically against hepatitis B; and we show how these and other factors combined to make those vaccines an unexpected commercial success. Broadening the scope of our analysis to include not just North America and Europe but also low- and middle-income countries, we show how the development of the hepatitis B vaccines facilitated the emergence of a two-tier innovation system structured by tensions between the demands for commercial profitability on the one hand, and the expectation of public health benefit for low- and middle-income countries on the other.
MeSH term(s)	Biotechnology/trends ; Diffusion of Innovation ; Hepatitis B/prevention & control ; Hepatitis B Vaccines ; Humans ; Public Health ; Vaccines
Chemical Substances	Hepatitis B Vaccines ; Vaccines
Language	English
Publishing date	2017-05-13
Publishing country	England
Document type	Journal Article
ZDB-ID	1500765-0
ISSN	1879-2499 ; 1369-8486
ISSN (online)	1879-2499
ISSN	1369-8486
DOI	10.1016/j.shpsc.2017.05.004
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