Sun, sea, sand and silicone: mapping cosmetic surgery tourism

This multi-site, mixed methods project charted the experiences of British, Chinese and Australian patients travelling abroad for cosmetic surgery. Cosmetic surgery tourism is a fast developing industry that incorporates novel forms of labour and organisational structures that cross national boundaries, as well as drawing together pre-existing medical and tourism infrastructure. While medical tourism has often been characterised as wealthy patients from the global south travelling to the global north for high quality medical treatment unavailable at home, cosmetic surgery patients often travel from global north to global south, but these patients are on modest incomes. Despite this they can sometimes access upmarket private hospitals beyond their reach back home, made possible by favourable currency rates, cheap flights and lower labour costs outside the richest countries in the world. UK and Australian patients travelled for surgeries that were popular back home – such as breast augmentation and uplift, ‘tummy tuck’, rhinoplasty and liposuction. Others travel regionally, for example within Europe, often also motivated by cost savings. There are important exceptions to this pattern: Chinese patients travelling to South Korea access more expensive but high quality cosmetic surgery unavailable back home. Here patients from abroad often seek particular types of surgery prevalent amongst South Koreans, for example eye or jawbone surgery, or high tech surgery, such as breast augmentation using the patient’s own fat and stem cells. Patients therefore travel from global north to global south, across regional borders, and many are also ex-patriates. UK patients in Spain were most usually already living in Southern Spain or Gibraltar. Monitoring the movements of cosmetic surgery tourists is important in predicting health tourism in the future. As public healthcare systems are increasingly squeezed, patients become consumers in search of cut price procedures, taking on the risks of the choices they make. This research aimed to broaden understandings of surgical tourist experiences, the organisations involved, and the implications for globalize

Retreating to nature : rethinking 'therapeutic landscapes'

There is a long history of removing oneself from ‘society’ in order to recuperate or repair. This paper considers a yoga and massage retreat in Southern Spain, and what opportunities this retreat experience might offer for recuperation and the creation of healthy bodies. The paper positions ‘nature’ as an active participant, and as ‘enrolled’ in the experiences of the retreat as a ‘therapeutic landscape’, and questions how and what particular aspects of yoga practice (in intimate relation with place) give rise to therapeutic experiences

‘Video Replay: Families, films and fantasy’ as a transformational text: Commentary on Valerie Walkerdine's ‘Video Replay’.

In this commentary I explore the significance of Valerie Walkerdine's paper ‘Video Replay: Families, Films and Fantasy’. I review its impact in 1986 and then discuss how some of its ideas about subjectivity and popular culture – specifically film - can be developed in the contemporary context. A recurring fantasy of Rocky II and its reception is that of social and psychological transformation. I address this theme by drawing on the work of Christopher Bollas to argue that Walkerdine's psychosocial analysis continues to facilitate, across a range of contexts, some of the transformational processes described in her article

The Micropolitics of Obesity: Materialism, Markets and Food Sovereignty

This article shifts focus from an individualised and anthropocentric perspective on obesity, and uses a new materialist analysis to explore the assemblages of materialities producing fat and slim bodies. We report data from a study of adults’ accounts of food decision-making and practices, investigating circulations of matter and desires that affect the production, distribution, accumulation and dispersal of fat, and disclose a micropolitics of obesity, which affects bodies in both ‘becoming-fat’ and ‘becoming-slim’ assemblages. These assemblages comprise bodies, food, fat, physical environments, food producers and processing industries, supermarkets and other food retailers and outlets, diet regimens and weight loss clubs, and wider social, cultural and economic formations, along with the thoughts, feelings, ideas and human desires concerning food consumption and obesity. The analysis reveals the significance of the marketisation of food, and discusses whether public health responses to obesity should incorporate a food sovereignty component

Discourse, affect and affliction

While much recent theorizing into affect has challenged the primacy of discourse in understanding social life, this paper is premised on the intertwining of affective experience with discursive meaning. Furthermore, appreciating the entwining of affect and discourse facilitates broader understanding into the illness experience, medical decision-making and experiences of healing. Today, the biomedical discourse carries particular affective weight that can saturate experiences of affliction. Cultural understandings of disease similarly shape affect that may emerge in affliction. Social meaning, more specifically stereotypes pertaining to identities, interweave with emotion also in the context of medical practice. The doctor-patient relationship is an affect-laden encounter where the entwining of affect with social assumptions carries important, yet poorly understood, repercussions for treatment decisions and for the furthering of health inequalities. Both the elusiveness and the power of affect that unfolds in relation to discursive meaning rest on the way in which affect dwells in and resounds through the body

Urban civic pride and the new localism

Civic pride relates to how places promote and defend local identity and autonomy. It is often championed as a key value and aspiration of local government. This paper argues that civic pride has been under‐examined in geography, and in particular the emotional meanings of pride need to be better understood. In response, I present an emotional analysis of civic pride and discuss its role in British cities, particularly in the context of urban regeneration and the UK's new localism agenda. In the latter part of the paper I provide a case study of Nottingham in England, where I employ a discourse analysis of recent urban policy and local media to examine how civic pride is being mobilised and contested in the city. Examining civic pride is important because it shapes and reflects the political values that local governments stand for and provides a basis for thinking about how emotions are used strategically (and problematically) in urban policy. This paper complements and challenges existing literature on cities by showing how civic pride shapes, but also obscures, the ideological politics of local government and how, as geographers, we might consider more seriously the ways forms of power, identity and inequality are reproduced and contested through emotions such as pride

Long-Term Trends in Phytoplankton Chlorophyll a and Size Structure in the Benguela Upwelling System

This is the final version. Available from American Geophysical Union (AGU) via the DOI in this record.The Benguela Upwelling System (BUS) is among the most productive ecosystems globally, supporting numerous fisheries and ecosystem services in Southern Africa. Sea-viewing Wide Field-of-view Sensor and Moderate-resolution Imaging Spectroradiometer-Aqua chlorophyll a (Chla) concentrations between September 1997 and February 2018 were used to investigate long-term trends in phytoplankton biomass and size structure (microphytoplankton [>20 μm], nanophytoplankton [2–20 μm], and picophytoplankton [<2 μm]) in the Northern Benguela, Southern Benguela (SB), and Agulhas Bank (AB) shelf and open ocean regions of the BUS. Trends in upwelling and correlations with Chla and size structure were examined. Increasing Chla and microphytoplankton trends occurred in the Northern Benguela shelf and open ocean, while decreases were evident on the SB shelf in all seasons. In the SB open ocean, small increases occurred during austral winter, with a decrease in spring. On the AB shelf, increases in Chla and microphytoplankton occurred in summer with decreases during the other seasons. Patterns differed in the AB open ocean, with increases in winter and spring and decreases in summer and autumn. Although R 2 values indicated that linear trends accounted for a reasonable portion of the variance, and most trends were statistically significant, they showed only small changes on the shelf domains and little to no change in the open ocean. Strong correlations between upwelling, Chla, and the size classes were observed, but distinct seasonal differences occurred in each region. This is the first 20-year analysis of phytoplankton biomass and community structure in the BUS and provides a baseline against which future changes can be monitored.NERC National Centre for Earth ObservationSouth African National Research Foundation (NRF)South African Department of Environmental Affair