Journal articles on the topic 'Common pill bug'

This paper expounds the model pile of various types and different loading measurement method, and introduces the model test of pile foundation; big full scale model test of pile foundation, pile foundation indoor common model test research and its limitations, this paper expounds the advantages and disadvantages of different test methods.

Settlement reducing pile foundation has recently been proposed as an important progress in the design theory of pile foundation, which is one type of deformation-based foundations. Compared with the common design method, settlement reducing pile foundation can greatly reduce the number of required piles. Aimed to the influence of pile cap, cushion, pile spacing, pile length on bearing behavior of settlement reducing pile foundation, the indoor tests on steel pipe settlement reducing pile foundation for immersed tunnel were carried out in sand. Based on uniform design, the six groups of tests with 3×4 pile groups were conducted, furthermore, earth pressure, axial force of pile shaft, and foundation settlement were measured. When the load applied increased, the plastic failure of the soil occurred under the corner of immersed tunnel. The result shows that the earth pressure distribution against immersed tunnel is similar to the normal base reaction in sand which is big in the center and small in the border. The correlation analysis result indicates that apply pile cap, reduce cushion thickness, increase pile spacing and increase pile length can increase the pile load sharing ratio. Compared with the average value of correlation coefficient of each influencing factor, pile length has the most remarkable effect on the pile load sharing ratio, then cushion and pile cap, and pile spacing has the minimal effect among these influencing factors. The research can provide a reference for design of relevant projects.

based on the finite element method of superstructure-the pile raft foundation-the foundation soil action and interaction are studied. Research shows that the common function is considered, fundamental overall settlement and differential settlement with the increase of floor of a nonlinear trend. The influence of superstructure form is bigger for raft stress, the upper structure existing in secondary stress, and the bending moment and axial force than conventional design method slants big; With the increase of the floors, pile load sharing ratio is reduced gradually,but soil load sharing ratio is increased. Along with the increase of the upper structure stiffness, the load focused on corner and side pile; Increasing thickness of raft, can reduce the certain differential settlement and foundation average settlement, thus reducing the upper structure of secondary stress and improving of foundation soil load sharing ratio, at the same time the distribution of counterforce on the pile head is more uneven under raft, thus requiring more uneven from raft stress, considering the piles under raft and the stress of soils to comprehensive determines a reasonable raft thickness, which makes the design safety economy. As the foundation soil modulus of deformation of foundation soil improvement, sharing the upper loads increases, counterforce on the pile head incline to average, raft maximum bending moment decrease gradually.

Abstract This paper argues that the Wukan Incident reflects the common difficulties faced at the state-society level by contemporary China as the country finds itself experiencing both an important strategic chapter in its development, and a period during which social problems are coming to the fore. As such, the task of developing an understanding of the Wukan Incident offers the chance to draw crucial lessons about China’s future political and economic development. Firstly, the modernization development model, according to which economic growth and development take precedence above all else, has already led to a building up of serious social problems. China’s future development efforts must draw on and put into practice the theories of the Scientific Outlook on Development. Secondly, the demands made by the villagers of Wukan could feasibly become political and economic problems common throughout the whole country. This includes issues such as how state-owned assets and land are dealt with; transparency of public finances; and safeguards for the democratic rights and interests of Chinese citizens. The government must face these difficulties and use reforms to tackle each of them. Should it fail to do so, these issues could spark a serious social crisis or even affect the stability of the political order. Thirdly, the current mechanisms by which the Party and the government respond to the public’s interest-related claims require urgent improvement. Finally, there is no magic pill to solve the political and economic problems faced in China today. Elections are certainly not a magic solution.

Tuberculosis, commonly known as TB, is the second most fatal infectious disease after AIDS, caused by bacterium calledMycobacterium tuberculosis. Prolonged treatment, high pill burden, low compliance, and stiff administration schedules are factors that are responsible for emergence of MDR and XDR cases of tuberculosis. Till date, only BCG vaccine is available which is ineffective against adult pulmonary TB, which is the most common form of disease. Various unique antibodies have been developed to overcome drug resistance, reduce the treatment regimen, and elevate the compliance to treatment. Therefore, we need an effective and robust system to subdue technological drawbacks and improve the effectiveness of therapeutic drugs which still remains a major challenge for pharmaceutical technology. Nanoparticle-based ideology has shown convincing treatment and promising outcomes for chronic infectious diseases. Different types of nanocarriers have been evaluated as promising drug delivery systems for various administration routes. Controlled and sustained release of drugs is one of the advantages of nanoparticle-based antituberculosis drugs over free drug. It also reduces the dosage frequency and resolves the difficulty of low poor compliance. This paper reviews various nanotechnology-based therapies which can be used for the treatment of TB.

Abstract Polypharmacy (typically defined as the concomitant use of 5 or more medications) affects 40-50% of older adults in the U.S., and is associated with geriatric syndromes, a higher risk of medication non-adherence, and adverse drug events. Medication non-adherence is a common frustrating clinical issue for clinicians who provide care for older adult patients. Simultaneously, patients often find medication regimens to be complicated and confusing. This may contribute to medication non-adherence, which may further lead to adverse drug events and/or negative health outcomes. The more medications a patient is taking, the higher the risk for non-adherence. Thirty-eight students enrolled in an adult-gerontology primary care nurse practitioner program were given a bag of five mock medications that are commonly prescribed for older adults. Students were instructed to follow the directions on each of the bottles for approximately one month. A private messaging system was available for students if refills were needed or if they had questions about their medications. A debriefing session for this month-long, ungraded simulation was held, at which time students returned medication bottles. Pill counts were not analyzed, but all returned bottles contained mock medications. Approximately 52.6% of students estimated adhering to the medication regimen 0-24% of the time, whereas 26.3% reported an adherence rate of 25-50%. The most commonly cited barrier to adherence (55.3%) was “forgetfulness”. Nearly all students (89.5%) reported that the exercise “very much” increased their awareness of challenges patients face when managing medications, and 97% cited an increased awareness of ways to improve medication adherence.

The article is an attempt to present the fi nal proof of the mythological origin, instead of the historical one, of the image of the Vedic Thunderer Indra as puraṁdará “breaker-down of forts” (Ralph T. H. Griffi th), or “stronghold-splitter” (Stephanie W. Jamison and Joel P. Brereton). The proof can be found in the Baltic (Lithuanian, Latvian and partly Byelorussian) analogues of the image. One Lithuanian example: Pasakojama, kad velnias iš akmenų statęs pilį. Perkūnas pastebėjęs, trenkęs ir sudaužęs pilį “They say that the devil had been bilding a fort (or stronghold, castle) of stones. (The thunder-god) Perkūnas beheld that, smote, and destroyed the fort,” etc. Moreover, Lith. pilis and Lat. pils are exact linguistic equivalents to Vedic pur, pura, puri, etc. It is also probable that there is a connection between the Baltic devil Lith. velnias, Lat. velns and the Vedic stronghold-demon vala. As the Baltic devil is a purely mythological being that usually hides from the Thunderer under big stones, stone piles, and stone constructions, it is unlikely that there is even a slightest hint of any historical event behind the plot. The same applies to his ‘forts' destroyed by the Thunder-god (cf. Lith. griauti “to thunder” and at the same time “to destroy”). Mythology can serve and has often served as an explanation of common life events, hence the quasi-historical legends, as the following Latvian one about the mound near the homestead Sakaiņu: Kādreiz pils īpašnieks apbraukājis savus laгkus. Ceļā uznākusi liela vētra un pērkoņa negaiss. Līdz ar kādu pērkoņa grāvienu pils nogrimusi “Once the landlord of the castle was taking a tour around his fi elds, when a heavy thunderstorm started. One of the thunderbolts made the castle collapse” The origin of the plot (particularly when the owner of the castle or manor is equated to devil) is apparently mythological, not historical. A similar parallel can be drawn with the case of the Vedic “breaker-down of forts” Indra: even if it refl ected a real event of warfare, the image itself sheerly originates in mythology, not in history.

The past three years have seen an overwhelming increase in the number of dysphonic patients in our clinics. This phenomenon goes hand in hand with increased opening of call centers nationwide and increased demand for teachers, singers and performers abroad. This article discusses simple steps for the Otolaryngologist interested in evaluating these patients with different voice demands. It is important to recognize these common voice problems and address them promptly, or to refer them accordingly to Voice Centers if necessary. Chief Complaint The most common chief complaint is change in the quality of the voice or hoarseness. Hoarseness means a change in the perception of one’s voice, described as harsh, raspy, “paos” or “malat.” Other complaints include breathiness, throat pain, neck pain, inability and unrealibility to reach high notes. Inability to reach high notes suggests edema of the vocal folds making them more plump, as can be found in reflux laryngitis, allergies, or smoking. Lesions such as nodules, polyps and cysts cannot be discounted because they prevent vocal fold closure especially during high notes1 Throat and neck pain without an accompanying history of infection may suggest muscle tension dysphonia, especially in a voice professional who later develops maladaptive ways of talking that could strain other throat and neck muscles in an effort to speak.2 Frequent throat clearing, a sensation of phlegm in the throat and cough are also important chief complaints that may lead the otolaryngologist to the cause of the voice problem. In the absence of upper respiratory tract infections and post-nasal discharge, these could be suggestive of laryngopharyngeal reflux.3 History Does the hoarseness occur on and off? Was it sudden? After shouting in a basketball event? Is it becoming worse and permanent? What triggers or relieves it? Intermittent hoarseness could be due to voice abuse and misuse especially in a voice professional. Sudden hoarseness especially after watching a basketball event could be suggestive of vocal fold hemorrhage. A voice problem becoming worse and permanent could be a growing polyp or cyst, vocal fold paralysis in laryngeal cancer or thyroid cancer. A long lecture triggering the hoarseness and rest relieving it may suggest soft nodules, or Reinke’s edema due to vocal fold trauma of voice abuse and misuse. To begin with, it is important to know the occupation of our patient. Is our patient a voice professional- someone who uses his or her voice for a living? Voice demands at work contribute to voice change significantly and voice abuse and misuse is one of the most common causes of hoarseness. What are the other associated symptoms? Medical problems like a recent bout of upper respiratory tract infection and allergies are among the most common causes of hoarseness and should not be discounted immediately. Symptoms of hyperacidity are also significant.4 Is there a history of breathiness and difficulty of breathing? Voice fatigue, tremor, hypo or hypernasal voice? Choking, globus, odynophagia or dysphagia? Neck pain or head and neck trauma? These questions can give clues to the clinician regarding the possible cause of the problem. Past Medical History Asthma, COPD, pulmonary malignancy are associated with voice changes due to decreased airflow. Gastric ulcers and GERD can be suggestive of associated laryngopharyngeal reflux disease changing the vocal fold mucosa leading to voice change.3 Parkinsonism, myasthenia, traumatic brain injury and movement disorders can cause tremors, weakness or strained voice quality. Rheumatoid arthritis, SLE, and other autoimmune disorders can cause voice changes such as paralysis in RA. Endocrine problems such as hypothyroidism can cause edema of the vocal folds leading to decrease in pitch. Thyroid cancer can cause vocal fold paralysis. A history of radiation secondary to malignancies in the head and neck can cause vocal fold scarring leading to voice change.1 Personality and psychiatric disorders also lead to diagnosis. The outgoing, type A personality usually has vocal fold nodules; while inhibited and shy persons have functional dysphonias.5 Traumatic life events are also very important to take note of. History of surgery for neck trauma, thyroid nodules or malignancies, spine, cardiac, pulmonary and brain surgeries or previous endotracheal intubation can cause voice changes, usually related to vocal fold mobility problems. 1 Medications such as inhalational steroids for asthma can cause fungal laryngitis. ARB and ACE inhibitors for hypertension can cause non specific vocal fold masses. Antitussives, decongestants, antihistamines and Vitamin C are known to cause dryness of the vocal folds. Pills with sexual hormones can cause either elevations or decreases in pitch.6 Smoking can cause polypoid conditions in the vocal folds, pre-malignant or malignant changes. Intake of alcohol, diet and lifestyle can contribute to reflux problems and dysphonia. Physical Examination Hearing the patient and forming a subjective impression of the patient’s voice should automatically be part of the interview process. Ranking the voice according to a standard scale is subjective but becomes increasingly reproducible and precise with training and experience. Voice can be evaluated according to pitch, loudness, and vocal quality. Pitch is the highness or lowness of the voice. Is the speaking voice too low for the soprano? This could be the problem why a trained singer would have dysphonia. Does the woman sound like a man over the phone? This could be Reinke’s edema, maybe she is a smoker as well. Does the adult male suddenly speak with elevated pitch? This could be vocal fold paralysis. Loudness is the power of the voice. This is due to the source of power, the lungs. Posture, type of breathing, technique or training can affect this. Systemic problems like generalized weakness and cachexia are contributory. Of course pulmonary problems can contribute to decreased power. Voice quality can be evaluated using the GRBAS system.7 Just hearing the voice and using this system is helpful in making an impression. G- grade R- roughness B- breathiness A- asthenia S- strain GRBAS uses a 0 to 3 scale (0= normal or absence of deviance; 1=slight deviance; 2=moderate deviance; 3= severe deviance). Grade relates to the overall voice quality, integrating all deviant components GRBAS Sounds Probable Conditions Roughness Grainy quality; diplophonic Vocal fold masses such as nodules, polyps, cysts, laryngitis Breathiness Airy Unilateral paralysis, bowing, atrophy, abductor spasmodic dysphonia Asthenia No voice Bilateral paralysis in paramedian position, vocal fold atrophy Strain Tight quality Abductor spasmodic dysphonia, muscle tension dysphonia Head and Neck Examination Palpating the neck, especially the base of the tongue, and neck muscles which are tense and tender can be suggestive of an ongoing muscle tension dysphonia as a cause of the voice change.8 Thyroid masses, neck nodes, etc can be helpful in leading the clinician to a diagnosis. Visualizing the larynx has evolved as advances in technology have improved the understanding of vocal fold anatomy, physiology and voice production. At present, there is no single laryngeal examination tool that is superior to the others. What is important is that it gives a thorough visualization of the anatomy and a good functional evaluation of the larynx. Selecting the appropriate instrumentation will be possible if we recognize the advantages and limitations of the diagnostic tool we are using.9 Sometimes, a combination of these tools is important to make an accurate diagnosis. Advantages and Limitations of the Different Instruments to Visualize the Larynx Instrument Advantages Limitations Indirect Mirror Laryngoscopy Readily available; inexpensive Gives a gross idea of the anatomy; mobility; mucus; and mass (if big enough) Limited in patients who are hypergag; patient is not in a normal physiologic position; hard to detect paresis and small lesions Transnasal Flexible laryngoscopy Helpful for hypergag patients; patients physiology involving the tongue, pharynx and palate are well visualized; can assess paresis from paralysis; can be recorded for review Small lesions are hard to differentiate; color might not be reliable depending on the camera; may be expensive Rigid 70 or 90 degrees laryngoscope Extremely clear and magnified view; less expensive; can be recorded for review Limited in patients who are hypergag; patient is not in a normal physiologic position; hard to detect paresis and muscle tension dysphonia Videostroboscopy10 Provides a slow motion evaluation of vocal fold vibratory pattern, closure, mucosal wave; can differentiate benign vocal fold lesions Expensive; requires additional training Some helpful vocal tasks when using a flexible scope: Task Endoscopic Findings /ii/ Adduction Sniff Abduction Hee-hee-hee Either decreased adduction or abduction Sniff then /ii/ Fatigues the vocal folds; detects paresis/ weakness /ii/ glide form low to high pitch ability to lengthen the vocal folds Despite technological advances in laryngology, a good history and physical examination are still crucial in the diagnosis of voice disorders. Certain clues can be provided by a good history that especially point to a hoarse patient. Because no single instrument is superior for visualization of the larynx, it is important to recognize the advantages and limitations of each.

Dear Editor, Thyroidectomy is a common surgical procedure performed by us otolaryngologists on our patients. Quite often, we make our post-operative rounds on them, not knowing that the patient may have a lot of concerns regarding his or her operation that we somehow take lightly or worse, do not take seriously. I would like to share with other Ear Nose Throat (ENT) surgeons how it was to be a patient who underwent total thyroidectomy. My journey began in the mid- 1990s with an incidental finding of thyroid nodules when I underwent a Magnetic Resonance Imaging (MRI) of the cervical spine. It was then when I started medical suppression and yearly thyroid ultrasound examinations. However as the years passed, the nodules became more numerous involving both lobes and enlarging. It was last July when ultrasonography revealed that 2 of the nodules were solid and large. I then underwent ultrasound guided Fine Needle Aspiration Biopsy of the thyroid nodules for which the result was Bethesda 1 (the biopsy was non-conclusive). It was unanimously decided by the endocrinologist and my ENT surgeons, Dr. Alfredo Pontejos Jr. and Dr. Arsensio Cabungcal, that I would undergo total thyroidectomy. I had myself admitted at the Manila Doctors Hospital (MDH) on September 18, 2017 and underwent the surgical procedure on September 19, 2017. Pre-operatively, I told the ENT chief resident, Dr. Catherine Oseña my special “bilins”: 1) that I had a cervical spine problem so I could not hyperextend the neck; 2) that I was allergic to Penicillin; 3) that I had ceased antiplatelets (Clopidogrel, Aspirin) and fish oil omega for one week; 4) I had allergies to some non-steroidal anti-inflammatory drugs (NSAIDs); 5) if possible the suturing be subcuticular so that there wouldn’t be any need to remove any stitches post-op; and 6) the superior thyroid artery be ligated 2 times and the end of the stump sealed by harmonic scalpel. I had some anxieties regarding the surgery: losing my voice, undergoing tracheostomy for bilateral abductor paralysis since both thyroid lobes would be removed, having a malignant histopathologic result and hypocalcemia. DAY 0: “This is it”, I said to myself, when the nurse fetched me from my room at 6:00 AM to be brought to the operating room (O.R.) for my 7:00 AM schedule. At the O.R., everybody who saw me greeted me with phrases such as “Ikaw pala ang pasyente, kaya mo yan,” “Good luck” and “God bless.” Here I saw one of my surgeons, Dr. Cabungcal enter the OR suite. It was then when I saw my anesthesiologists, Dr. Ariel La Rosa and Dr. Greg Macasaet. The last memory I had pre-op was that of Dr. La Rosa inserting an intravenous (I.V.) line in my right wrist and that was the last thing I remembered. I woke up, already in the Post-Anesthesia Care Unit (PACU) or Recovery Room (RR) when I felt severe pain in my neck (surgical area). I also wanted to fix the pillow at the back of my head, but I did not want to cause any strain on my anterior neck. It was also here when I was very happy to hear my own voice. It was then I said that the surgeons preserved my voice. “Whataguys!” I said to my self, “Thank God.” It was very painful then, I remember the PACU nurse injecting something thru my I.V. line. I felt the medication run thru the I.V. line towards my arm and throughout my body and this made me sleep again (later I found out that it was nalbuphine). I recognize seeing my wife Lil, my son Vinci and the ENT resident, Dr. Dindo Retreta at the PACU. The medication I was given made me sleep again. I woke up again and heard that I was being wheeled out of the PACU to be brought to my room. I only learned later that I slept about an hour after the nalbuphine was given. In my hospital room, the pain in the neck was really painful (9/10) and I had difficulty expelling the phlegm from my trachea. Each time I swallowed my saliva, I could feel my trachea move up with accompanying pain. When the resident-on-duty (ROD) visited, I was given N-acetylcysteine effervescent tablet BID (Ed: bis in die; twice a day) that was very helpful as it made my expectoration easier. I could feel the pressure dressing over my neck, which was now stiff due to dried blood. I had my first meal at around 4:00 PM. I remember it was a tuna sandwich and cold water which I drank using a straw from the hospital plastic cup. Every bite and swallow was painful in the neck and throat. I could not detect whether the pain was coming from the throat or from the surgical site. My antibiotic was given I.V. and so was the pain reliever parecoxib, paracetamol and tranexamic acid. I still did not resume the blood thinners to prevent any post-op bleeding. I tried to get up after dinner to walk around but warm serosnguinous fluid came out of the drain soaking my hospital gown. I then had the nurse call the ENT ROD to change my thyroid dressing. In a few minutes, a new fluffy gauze pressure dressing was applied by the ROD and my hospital gown was replaced. I had a good sleep with some pain still at the surgical site and throat. DAY 1: The day started with Holy Communion in my room, a good breakfast and my usual morning breakfast pills (thyroxine, nevibolol and folic acid). The residents came and changed the dressing. The resident “milked” the neck trying to see if there was any accumulated blood or serum at the surgical site. This was the most painful of the whole surgical experience (10/10), and it was good news that there was no hematoma in the operative site. They then mobilized the drain by a few centimeters. The dressing was still replaced with less fluffy dressing. I have allergic rhinitis, and the act of sneezing caused recurrent pain in the surgical site, so I asked for an antihistamine tablet. My neck and throat were still painful on Day 1 (8/10) but relieved every time the I.V. analgesic was given. In the afternoon, I had a sponge bath given by the nurse on duty with me lying in bed. I still had throat phlegm but thanks to the acetylcysteine effervescent tablet it was easier to expectorate. Every time the ROD made rounds, he checked for hypocalcemia-- fortunately I did not have it. DAY 2: The day again started with Holy Communion and breakfast in my hospital room. My main attending surgeon, Dr. Pontejos made his rounds late morning and he changed the dressing and removed the drain. I was here that I realized that the superior and inferior flaps including the incision were all numb. There was no pain on drain removal as well as on tying of the standby suture to close the drain site. They were all numb. At this point, I realized that in all our patients, this removal of the drain and the tying the standby suture were painless. After a bath in the mid-afternoon before discharge, I was then feeling better but the pain was still there (7/10). On the way home, I bought some sterile gauze, plaster, mupirocin ointment and hydrogen peroxide (H2O2) for my neck wound dressing at home. DAY 3. The pain was less (5/10), and I did not have to take any analgesic from hereon. Bathing became a problem, but I devised a way to bathe that I adopted for the following days. In the shower, I first shampooed by hair with my head and face facing down with my wife holding the telephone shower and focusing it where it was needed. After this I dried my head and hair with a clean towel then bathed the rest of the body in standing position with the telephone shower targeting the area needing to be rinsed. I did this method of bathing for a week until I decided that I could now bathe without my head looking down. I was at rest at home for 2 weeks. DAY 6: It was one of the best days of my life when the chief resident told me that the histopathologic result was multinodular goiter and no malignancy. Yehey! Thanks to God! God is really good! To summarize some of the things I want to share with other thyroid surgeons: I didn’t realize that the post-op pain was really painful, so I can now understand my patients if they experience pain post-operatively. It was difficult to expel throat phlegm and the N-acetylcysteine effervescent tablet was a big help in liquefying the phlegm. The whole area is numb (superior and inferior flaps), thus the removal of the drain and sutures would not cause any pain on the patient. The “milking” of the site was painful and this procedure should be gently done. If the patient has nasal allergy, cover the patient with an antihistamine to prevent sneezing and unnecessary pain. Teach your patient the way I bathed and order a sponge bath on Day 1 and 2. I hope this sharing of experience will benefit all your patients who will undergo the same procedure- thyroidectomy. I would like to thank my surgeons (Dr. Alfredo Pontejos Jr. and Dr. Arsenio Cabungcal), the anesthesiologists (Dr. Ariel La Rosa and Dr. Greg Macasaet), the surgical assistants (MDH ORL residents – Drs. Catehrine Elise Oseña and Dindo Retreta), my endocrinologist Dr. Robert Mirasol and my Cardiologist Dr. Rogelio Tangco, for the excellent job, well done. I would like to thank my family-- Lil my wife, Vinci, Ericka, Raymond for their love and support and for taking care of me. I would like to thank the MDH ORL Residents for taking care of me and for a job well done as well. I would also like to thank all the nursing staff at the MDH tower 1 and the OR, PACU nurses for taking care of me as well. Sincerely yours, Cesar V. Villafuerte Jr. MD, MHA

Background and Objective: Suicide attempts are 10-20X more common than completed suicide and an important risk factor for death by suicide, yet most people who attempt suicide do not die by suicide. The process of recovering after a suicide attempt has not been well studied. The Reasons to go on Living (RTGOL) Project, a narrative web-based study, focuses on experiences of people who have attempted suicide and made the decision to go on living, a process not well studied. Narrative research is ideally suited to understanding personal experiences critical to recovery following a suicide attempt, including the transition to a state of hopefulness. Voices from people with lived experience can help us plan and conceptualize this work. This paper reports on a secondary research question of the larger study: what stories do participants tell of the positive role/impact of the mental health system. Material and Methods: A website created for The RTGOL Project (www.thereasons.ca) enabled participants to anonymously submit a story about their suicide attempt and recovery, a process which enabled participation from a large and diverse group of participants. The only direction given was “if you have made a suicide attempt or seriously considered suicide and now want to go on living, we want to hear from you.” The unstructured narrative format allowed participants to describe their experiences in their own words, to include and emphasize what they considered important. Over 5 years, data analysis occurred in several phases over the course of the study, resulting in the identification of data that were inputted into an Excel file. This analysis used stories where participants described positive involvement with the mental health system (50 stories). Results: Several participants reflected on experiences many years previous, providing the privilege of learning how their life unfolded, what made a difference. Over a five-year period, 50 of 226 stories identified positive experiences with mental health care with sufficient details to allow analysis, and are the focus of this paper. There were a range of suicidal behaviours in these 50 stories, from suicidal ideation only to medically severe suicide attempts. Most described one or more suicide attempts. Three themes identified included: 1) trust and relationship with a health care professional, 2) the role of friends and family and friends, and 3) a wide range of services. Conclusion: Stories open a window into the experiences of the period after a suicide attempt. This study allowed for an understanding of how mental health professionals might help individuals who have attempted suicide write a different story, a life-affirming story. The stories that participants shared offer some understanding of “how” to provide support at a most-needed critical juncture for people as they interact with health care providers, including immediately after a suicide attempt. Results of this study reinforce that just one caring professional can make a tremendous difference to a person who has survived a suicide attempt. Key Words: web-based; suicide; suicide attempt; mental health system; narrative research Word Count: 478 Introduction My Third (or fourth) Suicide AttemptI laid in the back of the ambulance, the snow of too many doses of ativan dissolving on my tongue.They hadn't even cared enough about meto put someone in the back with me,and so, frustrated,I'd swallowed all the pills I had with me— not enough to do what I wanted it to right then,but more than enough to knock me out for a good 14 hours.I remember very little after that;benzodiazepines like ativan commonly cause pre- and post-amnesia, says Google helpfullyI wake up in a locked rooma woman manically drawing on the windows with crayonsthe colors of light through the glassdiffused into rainbows of joy scattered about the roomas if she were coloring on us all,all of the tattered remnants of humanity in a psych wardmade into a brittle mosaic, a quilt of many hues, a Technicolor dreamcoatand I thoughtI am so glad to be able to see this. (Story 187)The nurse opening that door will have a lasting impact on how this story unfolds and on this person’s life. Each year, almost one million people die from suicide, approximately one death every 40 seconds. Suicide attempts are much more frequent, with up to an estimated 20 attempts for every death by suicide.1 Suicide-related behaviours range from suicidal ideation and self-injury to death by suicide. We are unable to directly study those who die by suicide, but effective intervention after a suicide attempt could reduce the risk of subsequent death by suicide. Near-fatal suicide attempts have been used to explore the boundary with completed suicides. Findings indicated that violent suicide attempters and serious attempters (seriousness of the medical consequences to define near-fatal attempts) were more likely to make repeated, and higher lethality suicide attempts.2 In a case-control study, the medically severe suicide attempts group (78 participants), epidemiologically very similar to those who complete suicide, had significantly higher communication difficulties; the risk for death by suicide multiplied if accompanied by feelings of isolation and alienation.3 Most research in suicidology has been quantitative, focusing almost exclusively on identifying factors that may be predictive of suicidal behaviours, and on explanation rather than understanding.4 Qualitative research, focusing on the lived experiences of individuals who have attempted suicide, may provide a better understanding of how to respond in empathic and helpful ways to prevent future attempts and death by suicide.4,5 Fitzpatrick6 advocates for narrative research as a valuable qualitative method in suicide research, enabling people to construct and make sense of the experiences and their world, and imbue it with meaning. A review of qualitative studies examining the experiences of recovering from or living with suicidal ideation identified 5 interconnected themes: suffering, struggle, connection, turning points, and coping.7 Several additional qualitative studies about attempted suicide have been reported in the literature. Participants have included patients hospitalized for attempting suicide8, and/or suicidal ideation,9 out-patients following a suicide attempt and their caregivers,10 veterans with serious mental illness and at least one hospitalization for a suicide attempt or imminent suicide plan.11 Relationships were a consistent theme in these studies. Interpersonal relationships and an empathic environment were perceived as therapeutic and protective, enabling the expression of thoughts and self-understanding.8 Given the connection to relationship issues, the authors suggested it may be helpful to provide support for the relatives of patients who have attempted suicide. A sheltered, friendly environment and support systems, which included caring by family and friends, and treatment by mental health professionals, helped the suicidal healing process.10 Receiving empathic care led to positive changes and an increased level of insight; just one caring professional could make a tremendous difference.11 Kraft and colleagues9 concluded with the importance of hearing directly from those who are suicidal in order to help them, that only when we understand, “why suicide”, can we help with an alternative, “why life?” In a grounded theory study about help-seeking for self-injury, Long and colleagues12 identified that self-injury was not the problem for their participants, but a panacea, even if temporary, to painful life experiences. Participant narratives reflected a complex journey for those who self-injured: their wish when help-seeking was identified by the theme “to be treated like a person”. There has also been a focus on the role and potential impact of psychiatric/mental health nursing. Through interviews with experienced in-patient nurses, Carlen and Bengtsson13 identified the need to see suicidal patients as subjective human beings with unique experiences. This mirrors research with patients, which concluded that the interaction with personnel who are devoted, hope-mediating and committed may be crucial to a patient’s desire to continue living.14 Interviews with individuals who received mental health care for a suicidal crisis following a serious attempt led to the development of a theory for psychiatric nurses with the central variable, reconnecting the person with humanity across 3 phases: reflecting an image of humanity, guiding the individual back to humanity, and learning to live.15 Other research has identified important roles for nurses working with patients who have attempted suicide by enabling the expression of thoughts and developing self-understanding8, helping to see things differently and reconnecting with others,10 assisting the person in finding meaning from their experience to turn their lives around, and maintain/and develop positive connections with others.16 However, one literature review identified that negative attitudes toward self-harm were common among nurses, with more positive attitudes among mental health nurses than general nurses. The authors concluded that education, both reflective and interactive, could have a positive impact.17 This paper is one part of a larger web-based narrative study, the Reasons to go on Living Project (RTGOL), that seeks to understand the transition from making a suicide attempt to choosing life. When invited to tell their stories anonymously online, what information would people share about their suicide attempts? This paper reports on a secondary research question of the larger study: what stories do participants tell of the positive role/impact of the mental health system. The focus on the positive impact reflects an appreciative inquiry approach which can promote better practice.18 Methods Design and Sample A website created for The RTGOL Project (www.thereasons.ca) enabled participants to anonymously submit a story about their suicide attempt and recovery. Participants were required to read and agree with a consent form before being able to submit their story through a text box or by uploading a file. No demographic information was requested. Text submissions were embedded into an email and sent to an account created for the Project without collecting information about the IP address or other identifying information. The content of the website was reviewed by legal counsel before posting, and the study was approved by the local Research Ethics Board. Stories were collected for 5 years (July 2008-June 2013). The RTGOL Project enabled participation by a large, diverse audience, at their own convenience of time and location, providing they had computer access. The unstructured narrative format allowed participants to describe their experiences in their own words, to include and emphasize what they considered important. Of the 226 submissions to the website, 112 described involvement at some level with the mental health system, and 50 provided sufficient detail about positive experiences with mental health care to permit analysis. There were a range of suicidal behaviours in these 50 stories: 8 described suicidal ideation only; 9 met the criteria of medically severe suicide attempts3; 33 described one or more suicide attempts. For most participants, the last attempt had been some years in the past, even decades, prior to writing. Results Stories of positive experiences with mental health care described the idea of a door opening, a turning point, or helping the person to see their situation differently. Themes identified were: (1) relationship and trust with a Health Care Professional (HCP), (2) the role of family and friends (limited to in-hospital experiences), and (3) the opportunity to access a range of services. The many reflective submissions of experiences told many years after the suicide attempt(s) speaks to the lasting impact of the experience for that individual. Trust and Relationship with a Health Care Professional A trusting relationship with a health professional helped participants to see things in a different way, a more hopeful way and over time. “In that time of crisis, she never talked down to me, kept her promises, didn't panic, didn't give up, and she kept believing in me. I guess I essentially borrowed the hope that she had for me until I found hope for myself.” (Story# 35) My doctor has worked extensively with me. I now realize that this is what will keep me alive. To be able to feel in my heart that my doctor does care about me and truly wants to see me get better.” (Story 34). The writer in Story 150 was a nurse, an honours graduate. The 20 years following graduation included depression, hospitalizations and many suicide attempts. “One day after supper I took an entire bottle of prescription pills, then rode away on my bike. They found me late that night unconscious in a downtown park. My heart threatened to stop in the ICU.” Then later, “I finally found a person who was able to connect with me and help me climb out of the pit I was in. I asked her if anyone as sick as me could get better, and she said, “Yes”, she had seen it happen. Those were the words I had been waiting to hear! I quickly became very motivated to get better. I felt heard and like I had just found a big sister, a guide to help me figure out how to live in the world. This person was a nurse who worked as a trauma therapist.” At the time when the story was submitted, the writer was applying to a graduate program. Role of Family and Friends Several participants described being affected by their family’s response to their suicide attempt. Realizing the impact on their family and friends was, for some, a turning point. The writer in Story 20 told of experiences more than 30 years prior to the writing. She described her family of origin as “truly dysfunctional,” and she suffered from episodes of depression and hospitalization during her teen years. Following the birth of her second child, and many family difficulties, “It was at this point that I became suicidal.” She made a decision to kill herself by jumping off the balcony (6 stories). “At the very last second as I hung onto the railing of the balcony. I did not want to die but it was too late. I landed on the parking lot pavement.” She wrote that the pain was indescribable, due to many broken bones. “The physical pain can be unbearable. Then you get to see the pain and horror in the eyes of someone you love and who loves you. Many people suggested to my husband that he should leave me in the hospital, go on with life and forget about me. During the process of recovery in the hospital, my husband was with me every day…With the help of psychiatrists and a later hospitalization, I was actually diagnosed as bipolar…Since 1983, I have been taking lithium and have never had a recurrence of suicidal thoughts or for that matter any kind of depression.” The writer in Story 62 suffered childhood sexual abuse. When she came forward with it, she felt she was not heard. Self-harm on a regular basis was followed by “numerous overdoses trying to end my life.” Overdoses led to psychiatric hospitalizations that were unhelpful because she was unable to trust staff. “My way of thinking was that ending my life was the only answer. There had been numerous attempts, too many to count. My thoughts were that if I wasn’t alive I wouldn’t have to deal with my problems.” In her final attempt, she plunged over the side of a mountain, dropping 80 feet, resulting in several serious injuries. “I was so angry that I was still alive.” However, “During my hospitalization I began to realize that my family and friends were there by my side continuously, I began to realize that I wasn't only hurting myself. I was hurting all the important people in my life. It was then that I told myself I am going to do whatever it takes.” A turning point is not to say that the difficulties did not continue. The writer of Story 171 tells of a suicide attempt 7 years previous, and the ongoing anguish. She had been depressed for years and had thoughts of suicide on a daily basis. After a serious overdose, she woke up the next day in a hospital bed, her husband and 2 daughters at her bed. “Honestly, I was disappointed to wake up. But, then I saw how scared and hurt they were. Then I was sorry for what I had done to them. Since then I have thought of suicide but know that it is tragic for the family and is a hurt that can never be undone. Today I live with the thought that I am here for a reason and when it is God's time to take me then I will go. I do believe living is harder than dying. I do believe I was born for a purpose and when that is accomplished I will be released. …Until then I try to remind myself of how I am blessed and try to appreciate the wonders of the world and the people in it.” Range of Services The important role of mental health and recovery services was frequently mentioned, including dialectical behavioural therapy (DBT)/cognitive-behavioural therapy (CBT), recovery group, group therapy, Alcoholics Anonymous, accurate diagnosis, and medications. The writer in Story 30 was 83 years old when she submitted her story, reflecting on a life with both good and bad times. She first attempted suicide at age 10 or 12. A serious post-partum depression followed the birth of her second child, and over the years, she experienced periods of suicidal intent: “Consequently, a few years passed and I got to feeling suicidal again. I had pills in one pocket and a clipping for “The Recovery Group” in the other pocket. As I rode on the bus trying to make up my mind, I decided to go to the Recovery Group first. I could always take the pills later. I found the Recovery Group and yoga helpful; going to meetings sometimes twice a day until I got thinking more clearly and learned how to deal with my problems.” Several participants described the value of CBT or DBT in learning to challenge perceptions. “I have tools now to differentiate myself from the illness. I learned I'm not a bad person but bad things did happen to me and I survived.”(Story 3) “The fact is that we have thoughts that are helpful and thoughts that are destructive….. I knew it was up to me if I was to get better once and for all.” (Story 32): “In the hospital I was introduced to DBT. I saw a nurse (Tanya) every day and attended a group session twice a week, learning the techniques. I worked with the people who wanted to work with me this time. Tanya said the same thing my counselor did “there is no study that can prove whether or not suicide solves problems” and I felt as though I understood it then. If I am dead, then all the people that I kept pushing away and refusing their help would be devastated. If I killed myself with my own hand, my family would be so upset. DBT taught me how to ‘ride my emotional wave’. ……….. DBT has changed my life…….. My life is getting back in order now, thanks to DBT, and I have lots of reasons to go on living.”(Story 19) The writer of Story 67 described the importance of group therapy. “Group therapy was the most helpful for me. It gave me something besides myself to focus on. Empathy is such a powerful emotion and a pathway to love. And it was a huge relief to hear others felt the same and had developed tools of their own that I could try for myself! I think I needed to learn to communicate and recognize when I was piling everything up to build my despair. I don’t think I have found the best ways yet, but I am lifetimes away from that teenage girl.” (Story 67) The author of story 212 reflected on suicidal ideation beginning over 20 years earlier, at age 13. Her first attempt was at 28. “I thought everyone would be better off without me, especially my children, I felt like the worst mum ever, I felt like a burden to my family and I felt like I was a failure at life in general.” She had more suicide attempts, experienced the death of her father by suicide, and then finally found her doctor. “Now I’m on meds for a mood disorder and depression, my family watch me closely, and I see my doctor regularly. For the first time in 20 years, I love being a mum, a sister, a daughter, a friend, a cousin etc.” Discussion The 50 stories that describe positive experiences in the health care system constitute a larger group than most other similar studies, and most participants had made one or more suicide attempts. Several writers reflected back many years, telling stories of long ago, as with the 83-year old participant (Story 30) whose story provided the privilege of learning how the author’s life unfolded. In clinical practice, we often do not know – how did the story turn out? The stories that describe receiving health care speak to the impact of the experience, and the importance of the issues identified in the mental health system. We identified 3 themes, but it was often the combination that participants described in their stories that was powerful, as demonstrated in Story 20, the young new mother who had fallen from a balcony 30 years earlier. Voices from people with lived experience can help us plan and conceptualize our clinical work. Results are consistent with, and add to, the previous work on the importance of therapeutic relationships.8,10,11,14–16 It is from the stories in this study that we come to understand the powerful experience of seeing a family members’ reaction following a participant’s suicide attempt, and how that can be a potent turning point as identified by Lakeman and Fitzgerald.7 Ghio and colleagues8 and Lakeman16 identified the important role for staff/nurses in supporting families due to the connection to relationship issues. This research also calls for support for families to recognize the important role they have in helping the person understand how much they mean to them, and to promote the potential impact of a turning point. The importance of the range of services reflect Lakeman and Fitzgerald’s7 theme of coping, associating positive change by increasing the repertoire of coping strategies. These findings have implications for practice, research and education. Working with individuals who are suicidal can help them develop and tell a different story, help them move from a death-oriented to life-oriented position,15 from “why suicide” to “why life.”9 Hospitalization provides a person with the opportunity to reflect, to take time away from “the real world” to consider oneself, the suicide attempt, connections with family and friends and life goals, and to recover physically and emotionally. Hospitalization is also an opening to involve the family in the recovery process. The intensity of the immediate period following a suicide attempt provides a unique opportunity for nurses to support and coach families, to help both patients and family begin to see things differently and begin to create that different story. In this way, family and friends can be both a support to the person who has attempted suicide, and receive help in their own struggles with this experience. It is also important to recognize that this short period of opportunity is not specific to the nurses in psychiatric units, as the nurses caring for a person after a medically severe suicide attempt will frequently be the nurses in the ICU or Emergency departments. Education, both reflective and interactive, could have a positive impact.17 Helping staff develop the attitudes, skills and approach necessary to be helpful to a person post-suicide attempt is beginning to be reported in the literature.21 Further implications relate to nursing curriculum. Given the extent of suicidal ideation, suicide attempts and deaths by suicide, this merits an important focus. This could include specific scenarios, readings by people affected by suicide, both patients themselves and their families or survivors, and discussions with individuals who have made an attempt(s) and made a decision to go on living. All of this is, of course, not specific to nursing. All members of the interprofessional health care team can support the transition to recovery of a person after a suicide attempt using the strategies suggested in this paper, in addition to other evidence-based interventions and treatments. Findings from this study need to be considered in light of some specific limitations. First, the focus was on those who have made a decision to go on living, and we have only the information the participants included in their stories. No follow-up questions were possible. The nature of the research design meant that participants required access to a computer with Internet and the ability to communicate in English. This study does not provide a comprehensive view of in-patient care. However, it offers important inputs to enhance other aspects of care, such as assessing safety as a critical foundation to care. We consider these limitations were more than balanced by the richness of the many stories that a totally anonymous process allowed. Conclusion Stories open a window into the experiences of a person during the period after a suicide attempt. The RTGOL Project allowed for an understanding of how we might help suicidal individuals change the script, write a different story. The stories that participants shared give us some understanding of “how” to provide support at a most-needed critical juncture for people as they interact with health care providers immediately after a suicide attempt. While we cannot know the experiences of those who did not survive a suicide attempt, results of this study reinforce that just one caring professional can make a crucial difference to a person who has survived a suicide attempt. We end with where we began. Who will open the door? References 1. World Health Organization. Suicide prevention and special programmes. http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/index.html Geneva: Author; 2013.2. Giner L, Jaussent I, Olie E, et al. Violent and serious suicide attempters: One step closer to suicide? J Clin Psychiatry 2014:73(3):3191–197.3. Levi-Belz Y, Gvion Y, Horesh N, et al. Mental pain, communication difficulties, and medically serious suicide attempts: A case-control study. Arch Suicide Res 2014:18:74–87.4. Hjelmeland H and Knizek BL. Why we need qualitative research in suicidology? Suicide Life Threat Behav 2010:40(1):74–80.5. Gunnell D. A population health perspective on suicide research and prevention: What we know, what we need to know, and policy priorities. Crisis 2015:36(3):155–60.6. Fitzpatrick S. Looking beyond the qualitative and quantitative divide: Narrative, ethics and representation in suicidology. Suicidol Online 2011:2:29–37.7. Lakeman R and FitzGerald M. How people live with or get over being suicidal: A review of qualitative studies. J Adv Nurs 2008:64(2):114–26.8. Ghio L, Zanelli E, Gotelli S, et al. Involving patients who attempt suicide in suicide prevention: A focus group study. J Psychiatr Ment Health Nurs 2011:18:510–18.9. Kraft TL, Jobes DA, Lineberry TW., Conrad, A., & Kung, S. Brief report: Why suicide? Perceptions of suicidal inpatients and reflections of clinical researchers. Arch Suicide Res 2010:14(4):375-382.10. Sun F, Long A, Tsao L, et al. The healing process following a suicide attempt: Context and intervening conditions. Arch Psychiatr Nurs 2014:28:66–61.11. Montross Thomas L, Palinkas L, et al. Yearning to be heard: What veterans teach us about suicide risk and effective interventions. Crisis 2014:35(3):161–67.12. Long M, Manktelow R, and Tracey A. The healing journey: Help seeking for self-injury among a community population. Qual Health Res 2015:25(7):932–44.13. Carlen P and Bengtsson A. Suicidal patients as experienced by psychiatric nurses in inpatient care. Int J Ment Health Nurs 2007:16:257–65.14. Samuelsson M, Wiklander M, Asberg M, et al. Psychiatric care as seen by the attempted suicide patient. J Adv Nurs 2000:32(3):635–43.15. Cutcliffe JR, Stevenson C, Jackson S, et al. A modified grounded theory study of how psychiatric nurses work with suicidal people. Int J Nurs Studies 2006:43(7):791–802.16. Lakeman, R. What can qualitative research tell us about helping a person who is suicidal? Nurs Times 2010:106(33):23–26.17. Karman P, Kool N, Poslawsky I, et al. Nurses’ attitudes toward self-harm: a literature review. J Psychiatr Ment Health Nurs 2015:22:65–75.18. Carter B. ‘One expertise among many’ – working appreciatively to make miracles instead of finding problems: Using appreciative inquiry as a way of reframing research. J Res Nurs 2006:11(1): 48–63.19. Lieblich A, Tuval-Mashiach R, Zilber T. Narrative research: Reading, analysis, and interpretation. Sage Publications; 1998.20. Braun V and Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006:3(2):77–101.21. Kishi Y, Otsuka K, Akiyama K, et al. Effects of a training workshop on suicide prevention among emergency room nurses. Crisis 2014:35(5):357–61.

Aims: Peppers are common raw spices facing significant post-harvest lost in the handling train. This study was carried out to promote the production of pepper concentrate as spices extracts for foods. Study Design: Composite extracts formulated from raw peppers extracts using Central Composite Design, and resulted formulations submitted to sensory analysis. Place and Duration of Study: Laboratory of Biochemistry and Food Sciences, Department of Biochemistry, Training and Research Unit of Biosciences, Felix Houphouet-Boigny University, Abidjan, Côte d’Ivoire, between June and October 2018. Methodology: Using a central composite design, 25 peppers extract formulations (F1 to F25) were processed from raw extracts of four pepper varieties growing in Côte d’Ivoire, namely cultivars ‘’pili pili’’ and ‘’bill of bird’’ (Capsicum frutescens), ‘’pepper baoulé’’ (Capsicum annuum), and ‘’big sun’’ (Capsicum chinense). These formulations were then subjected to sensory descriptive and sensory acceptance analyses by panellists about the color appearance, the pungency flavor, the fluidity aspect, and the typical pepper aroma. Results: The sensory perception of pungency, fluidity, and aroma didn’t differentiate the formulations. But four formulations (F18, F20, F21, and F24) evidenced more intensive orange- yellowish appearance (4.44/7, 5.33/7, 4.33/7, and 4.67/7, respectively). From these formulations, samples F18 and F20 have been more enjoyed as food spices, with respective scores of 76.17% and 77.76% panellists. Conclusion: Both formulations F18 and F20 could be used as significant baselines in peppers extract processing for food interests.

IntroductionWhat can we learn about anomaly from the strangeness of a puppet, a lifeless object, that can both bleed and die? How does the filming process of a puppet’s death engage across media and produce a new media genre that is not easily classified within traditional conventions? Why do these fighting and bleeding puppets’ scenes consistently attract audiences? This study examines how Pili puppetry (1984-present), a popular TV series depicting martial arts-based narratives and fight sequences, interacts with digital technologies and constructs a new media genre. The transmedia constitution of a virtual world not only challenges the stereotype of puppetry’s target audience but also expands the audience’s bodily imagination and desires through the visual component of death scenes. Hence, the show does not merely represent or signify an anomaly, but even creates anomalous desires and imaginary bodies.Cultural commodification and advancing technologies have motivated the convergence and displacement of traditional boundaries, genres, and media, changing the very fabric of textuality itself. By exploring how new media affect the audience’s visual reception of fighting and death, this article sheds light on understanding the metamorphoses of Taiwanese puppetry and articulates a theoretical argument regarding the show’s artistic practice to explain how its form transverses traditional boundaries. This critical exploration focusses on how the form represents bleeding puppets, and in doing so, explicates the politics of transmedia performing and viewing. Pili is an example of an anomalous media form that proliferates anomalous media viewing experiences and desires in turn.Beyond a Media Genre: Taiwanese Pili PuppetryConverging the craft technique of puppeteering and digital technology of filmmaking and animation, Pili puppetry creates a new media genre that exceeds any conventional idea of a puppet show or digital puppet, as it is something in-between. Glove puppetry is a popular traditional theatre in Taiwan, often known as “theatre in the palm” because a traditional puppet was roughly the same size as an adult’s palm. The size enabled the puppeteer to easily manipulate a puppet in one hand and be close to the audience. Traditionally, puppet shows occurred to celebrate the local deities’ birthday. Despite its popularity, the form was limited by available technology. For instance, although stories with vigorous battles were particularly popular, bleeding scenes in such an auspicious occasion were inappropriate and rare. As a live theatrical event featuring immediate interaction between the performer and the spectator, realistic bleeding scenes were rare because it is hard to immediately clean the stage during the performance. Distinct from the traditional puppet show, digital puppetry features semi-animated puppets in a virtual world. Digital puppetry is not a new concept by any means in the Western film industry. Animating a 3D puppet is closely associated with motion capture technologies and animation that are manipulated in a digitalised virtual setting (Ferguson). Commonly, the target audience of the Western digital puppetry is children, so educators sometimes use digital puppetry as a pedagogical tool (Potter; Wohlwend). With these young target audience in mind, the producers often avoid violent and bleeding scenes.Pili puppetry differs from digital puppetry in several ways. For instance, instead of targeting a young audience, Pili puppetry consistently extends the traditional martial-arts performance to include bloody fight sequences that enrich the expressiveness of traditional puppetry as a performing art. Moreover, Pili puppetry does not apply the motion capture technologies to manipulate the puppet’s movement, thus retaining the puppeteers’ puppeteering craft (clips of Pili puppetry can be seen on Pili’s official YouTube page). Hence, Pili is a unique hybrid form, creating its own anomalous space in puppetry. Among over a thousand characters across the series, the realistic “human-like” puppet is one of Pili’s most popular selling points. The new media considerably intervene in the puppet design, as close-up shots and high-resolution images can accurately project details of a puppet’s face and body movements on the screen. Consequently, Pili’s puppet modelling becomes increasingly intricate and attractive and arguably makes its virtual figures more epic yet also more “human” (Chen). Figure 1: Su Huan-Jen in the TV series Pili Killing Blade (1993). His facial expressions were relatively flat and rigid then. Reproduced with permission of Pili International Multimedia Company.Figure 2: Su Huan-Jen in the TV series Pili Nine Thrones (2003). The puppet’s facial design and costume became more delicate and complex. Reproduced with permission of Pili International Multimedia Company.Figure 3: Su Huan-Jen in the TV series Pili Fantasy: War of Dragons (2019). His facial lines softened due to more precise design technologies. The new lightweight chiffon yarn costumes made him look more elegant. The multiple-layer costumes also created more space for puppeteers to hide behind the puppet and enact more complicated manipulations. Reproduced with permission of Pili International Multimedia Company.The design of the most well-known Pili swordsman, Su Huan-Jen, demonstrates how the Pili puppet modelling became more refined and intricate in the past 20 years. In 1993, the standard design was a TV puppet with the size and body proportion slightly enlarged from the traditional puppet. Su Huan-Jen’s costumes were made from heavy fabrics, and his facial expressions were relatively flat and rigid (fig. 1). Pili produced its first puppetry film Legend of the Sacred Stone in 2000; considering the visual quality of a big screen, Pili refined the puppet design including replacing wooden eyeballs and plastic hair with real hair and glass eyeballs (Chen). The filmmaking experience inspired Pili to dramatically improve the facial design for all puppets. In 2003, Su’s modelling in Pili Nine Thrones (TV series) became noticeably much more delicate. The puppet’s size was considerably enlarged by almost three times, so a puppeteer had to use two hands to manipulate a puppet. The complex costumes and props made more space for puppeteers to hide behind the puppet and enrich the performance of the fighting movements (fig. 2). In 2019, Su’s new modelling further included new layers of lightweight fabrics, and his makeup and props became more delicate and complex (fig. 3). Such a refined aesthetic design also lends to Pili’s novelty among puppetry performances.Through the transformation of Pili in the context of puppetry history, we see how the handicraft-like puppet itself gradually commercialised into an artistic object that the audience would yearn to collect and project their bodily imagination. Anthropologist Teri Silvio notices that, for some fans, Pili puppets are similar to worship icons through which they project their affection and imaginary identity (Silvio, “Pop Culture Icons”). Intermediating with the new media, the change in the refined puppet design also comes from the audience’s expectations. Pili’s senior puppet designer Fan Shih-Ching mentioned that Pili fans are very involved, so their preferences affect the design of puppets. The complexity, particularly the layer of costumes, most clearly differentiates the aesthetics of traditional and Pili puppets. Due to the “idolisation” of some famous Pili characters, Shih-Ching has had to design more and more gaudy costumes. Each resurgence of a well-known Pili swordsman, such as Su Huan-Jen, Yi Ye Shu, and Ye Hsiao-Chai, means he has to remodel the puppet.Pili fans represent their infatuation for puppet characters through cosplay (literally “costume play”), which is when fans dress up and pretend to be a Pili character. Their cosplay, in particular, reflects the bodily practice of imaginary identity. Silvio observes that most cosplayers choose to dress as characters that are the most visually appealing rather than characters that best suit their body type. They even avoid moving too “naturally” and mainly move from pose-to-pose, similar to the frame-to-frame techne of animation. Thus, we can understand this “cosplay more as reanimating the character using the body as a kind of puppet rather than as an embodied performance of some aspect of self-identity” (Silvio 2019, 167). Hence, Pili fans’ cosplay is indicative of an anomalous desire to become the puppet-like human, which helps them transcend their social roles in their everyday life. It turns out that not only fans’ preference drives the (re)modelling of puppets but also fans attempt to model themselves in the image of their beloved puppets. The reversible dialectic between fan-star and flesh-object further provokes an “anomaly” in terms of the relationship between the viewers and the puppets. Precisely because fans have such an intimate relationship with Pili, it is important to consider how the series’ content and form configure fans’ viewing experience.Filming Bleeding PuppetsDespite its intricate aesthetics, Pili is still a series with frequent fighting-to-the-death scenes, which creates, and is the result of, extraordinary transmedia production and viewing experiences. Due to the market demand of producing episodes around 500 minutes long every month, Pili constantly creates new characters to maintain the audience’s attention and retain its novelty. So far, Pili has released thousands of characters. To ensure that new characters supersede the old ones, numerous old characters have to die within the plot.The adoption of new media allows the fighting scenes in Pili to render as more delicate, rather than consisting of loud, intense action movements. Instead, the leading swordsmen’s death inevitably takes place in a pathetic and romantic setting and consummates with a bloody sacrifice. Fighting scenes in early Pili puppetry created in the late 1980s were still based on puppets’ body movements, as the knowledge and technology of animation were still nascent and underdeveloped. At that time, the prestigious swordsman mainly relied on the fast speed of brandishing his sword. Since the early 1990s, as animation technology matured, it has become very common to see Pili use CGI animation to create a damaging sword beam for puppets to kill target enemies far away. The sword beam can fly much faster than the puppets can move, so almost every fighting scene employs CGI to visualise both sword beams and flame. The change in fighting manners provokes different representations of the bleeding and death scenes. Open wounds replace puncture wounds caused by a traditional weapon; bleeding scenes become typical, and a special feature in Pili’s transmedia puppetry.In addition to CGI animation, the use of fake blood in the Pili studio makes the performance even more realistic. Pili puppet master Ting Chen-Ching recalled that exploded puppets in traditional puppetry were commonly made by styrofoam blocks. The white styrofoam chips that sprayed everywhere after the explosion inevitably made the performance seem less realistic. By contrast, in the Pili studio, the scene of a puppet spurting blood after the explosion usually applies the technology of editing several shots. The typical procedure would be a short take that captures a puppet being injured. In its injury location, puppeteers sprinkle red confetti to represent scattered blood clots in the following shot. Sometimes the fake blood was splashed with the red confetti to make it further three-dimensional (Ting). Bloody scenes can also be filmed through multiple layers of arranged performance conducted at the same time by a group of puppeteers. Ting describes the practice of filming a bleeding puppet. Usually, some puppeteers sprinkle fake blood in front of the camera, while other puppeteers blasted the puppets toward various directions behind the blood to make the visual effects match. If the puppeteers need to show how a puppet becomes injured and vomits blood during the fight, they can install tiny pipes in the puppet in advance. During the filming, the puppeteer slowly squeezes the pipe to make the fake blood flow out from the puppet’s mouth. Such a bloody scene sometimes accompanies tears dropping from the puppet’s eyes. In some cases, the puppeteer drops the blood on the puppet’s mouth prior to the filming and then uses a powerful electric fan to blow the blood drops (Ting). Such techniques direct the blood to flow laterally against the wind, which makes the puppet’s death more aesthetically tragic. Because it is not a live performance, the puppeteer can try repeatedly until the camera captures the most ideal blood drop pattern and bleeding speed. Puppeteers have to adjust the camera distance for different bleeding scenes, which creates new modes of viewing, sensing, and representing virtual life and death. One of the most representative examples of Pili’s bleeding scenes is when Su’s best friend, Ching Yang-Zi, fights with alien devils in Legend of the Sacred Stone. (The clip of how Ching Yang-Zi fights and bleeds to death can be seen on YouTube.) Ting described how Pili prepared three different puppets of Ching for the non-fighting, fighting, and bleeding scenes (Ting). The main fighting scene starts from a low-angle medium shot that shows how Ching Yang-Zi got injured and began bleeding from the corner of his mouth. Then, a sharp weapon flies across the screen; the following close-up shows that the weapon hits Ching and he begins bleeding immediately. The successive shots move back and forth between his face and the wound in medium shot and close-up. Next, a close-up shows him stepping back with blood dripping on the ground. He then pushes the weapon out of his body to defend enemies; a final close-up follows a medium take and a long take shows the massive hemorrhage. The eruption of fluid plasma creates a natural effect that is difficult to achieve, even with 3D animation. Beyond this impressive technicality, the exceptional production and design emphasise how Pili fully embraces the ethos of transmedia: to play with multiple media forms and thereby create a new form. In the case of Pili, its form is interactive, transcending the boundaries of what we might consider the “living” and the “dead”.Epilogue: Viewing Bleeding Puppets on the ScreenThe simulated, high-quality, realistic-looking puppet designs accompanying the Pili’s featured bloody fighting sequence draw another question: What is the effect of watching human-like puppets die? What does this do to viewer-fans? Violence is prevalent throughout the historical record of human behaviour, especially in art and entertainment because these serve as outlets to fulfill a basic human need to indulge in “taboo fantasies” and escape into “realms of forbidden experience” (Schechter). When discussing the visual representations of violence and the spectacle of the sufferings of others, Susan Sontag notes, “if we consider what emotions would be desirable” (102), viewing the pain of others may not simply evoke sympathy. She argues that “[no] moral charge attaches to the representation of these cruelties. Just the provocation: can you look at this? There is the satisfaction of being able to look at the image without flinching. There is the pleasure of flinching” (41). For viewers, the boldness of watching the bloody scenes can be very inviting. Watching human-like puppets die in the action scenes similarly validates the viewer’s need for pleasure and entertainment. Although different from a human body, the puppets still bears the materiality of being-object. Therefore, watching the puppets bleeding and die as distinctly “human-like’ puppets further prevent viewers’ from feeling guilty or morally involved. The conceptual distance of being aware of the puppet’s materiality acts as a moral buffer; audiences are intimately involved through the particular aesthetic arrangement, yet morally detached. The transmedia filming of puppetry adds another layer of mediation over the human-like “living” puppets that allows such a particular experience. Sontag notices that the media generates an inevitable distance between object and subject, between witness and victim. For Sontag, although images constitute “the imaginary proximity” because it makes the “faraway sufferers” be “seen close-up on the television screen”, it is a mystification to assume that images serve as a direct link between sufferers and viewers. Rather, Sontag insists: the distance makes the viewers feel “we are not accomplices to what caused the suffering. Our sympathy proclaims our innocence as well as our impotence” (102). Echoing Sontag’s argument, Jeffrey Goldstein points out that “distancing” oneself from the mayhem represented in media makes it tolerable. Media creates an “almost real” visuality of violence, so the audience feels relatively safe in their surroundings when exposed to threatening images. Thus, “violent imagery must carry cues to its unreality or it loses appeal” (280). Pili puppets that are human-like, thus not human, more easily enable the audience to seek sensational excitement through viewing puppets’ bloody violence and eventual death on the screen and still feel emotionally secure. Due to the distance granted by the medium, viewers gain a sense of power by excitedly viewing the violence with an accompanying sense of moral exemption. Thus, viewers can easily excuse the limits of their personal responsibility while still being captivated by Pili’s boundary-transgressing aesthetic.The anomalous power of Pili fans’ cosplay differentiates the viewing experience of puppets’ deaths from that of other violent entertainment productions. Cosplayers physically bridge viewing/acting and life/death by dressing up as the puppet characters, bringing them to life, as flesh. Cosplay allows fans to compensate for the helplessness they experience when watching the puppets’ deaths on the screen. They can both “enjoy” the innocent pleasure of watching bleeding puppets and bring their adored dead idols “back to life” through cosplay. The onscreen violence and death thus provide an additional layer of pleasure for such cosplayers. They not only take pleasure in watching the puppets—which are an idealized version of their bodily imagination—die, but also feel empowered to revitalise their loved idols. Therefore, Pili cosplayers’ desires incite a cycle of life, pleasure, and death, in which the company responds to their consumers’ demands in kind. The intertwining of social, economic, and political factors thus collectively thrives upon media violence as entertainment. Pili creates the potential for new cross-media genre configurations that transcend the traditional/digital puppetry binary. On the one hand, the design of swordsman puppets become a simulation of a “living object” responding to the camera distance. On the other hand, the fighting and death scenes heavily rely on the puppeteers’ cooperation with animation and editing. Therefore, Pili puppetry enriches existing discourse on both puppetry and animation as life-giving processes. What is animated by Pili puppetry is not simply the swordsmen characters themselves, but new potentials for media genres and violent entertainment. AcknowledgmentMy hearty gratitude to Amy Gaeta for sharing her insights with me on the early stage of this study.ReferencesChen, Jasmine Yu-Hsing. “Transmuting Tradition: The Transformation of Taiwanese Glove Puppetry in Pili Productions.” Journal of the Oriental Society of Australia 51 (2019): 26-46.Ferguson, Jeffrey. “Lessons from Digital Puppetry: Updating a Design Framework for a Perceptual User Interface.” IEEE International Conference on Computer and Information Technology, 2015.Goldstein, Jeffrey. “The Attractions of Violent Entertainment.” Media Psychology 1.3 (1999): 271-282.Potter, Anna. “Funding Contemporary Children’s Television: How Digital Convergence Encourages Retro Reboot.” International Journal on Communications Management 19.2 (2017): 108-112.Schechter, Harold. Savage Pastimes: A Cultural History of Violent Entertainment. New York: St. Martin’s, 2005.Silvio, Teri. “Pop Culture Icons: Religious Inflections of the Character Toy in Taiwan.” Mechademia 3.1 (2010): 200-220.———. Puppets, Gods, and Brands: Theorizing the Age of Animation from Taiwan. Honolulu: U Hawaii P, 2019. Sontag, Susan. Regarding the Pain of Others. New York: Farrar, Straus, and Giroux, 2004.Ting, Chen-Ching. Interview by the author. Yunlin, Taiwan. 24 June 2019.Wohlwend, Karen E. “One Screen, Many Fingers: Young Children's Collaborative Literacy Play with Digital Puppetry Apps and Touchscreen Technologies.” Theory into Practice 54.2 (2015): 154-162.

Responsibility frames in media coverage describe the mediated attribution of responsibility for causes and remedies (treatments, solutions) for health issues, mostly differentiating between individual and societal responsibility. Field of application/theoretical foundation: Media coverage of health topics, public opinion formation, attribution of responsibility, framing studies, social media on health issues Example studies: Gollust & Lantz (2009); Kim & Willis (2007); O’Hara & Smith (2007); Stefanik-Sidener (2013); Yoo & Kim (2012); Zhang & Jin (2015) Information on Kim & Willis, 2007 Authors: Sei-Hill Kim, Leigh Anne Willis Health topic: Obesity Research questions: How have the media presented the causes and solutions for obesity? Have certain causes and solutions appeared more often than others? How has media coverage of causal and solution responsibility changed over the years? Have mentions of certain causes and solutions increased or decreased? Object of analysis: Newspaper and television news data containing “obesity” or “obese” appearing in the headline, lead paragraphs, or index terms; articles published in The New York Times, The Washington Post, Chicago Sun-Times, The San Francisco Chronicle, The Houston Chronicle, and USA Today; news transcripts on obesity from three television networks (ABC, CBS, NBC); after conducting a systematic sampling, n = 300 articles and n = 200 transcripts were analyzed Time frame of analysis: January 1995 to August 2004 Info about variables Variables: Variables included attributions of causal and treatment responsibility, cause or treatment option was coded as ‘‘not present’’ (0) or ‘‘present’’ (1). Level of analysis: News article respectively tv transcript Causal responsibility Solution responsibility Personal causes (Scott’s pi= .81) Unhealthy diet: Consuming too much food, consuming too much unhealthy food, addictive or emotional eating. Sedentary lifestyle: Lack of exercise, Lack of physical activities. Genetic conditions: Genetic=biological factors that may produce obesity (e.g., imbalance of hunger hormones that may stimulate appetite). Others: E.g., poor adult role models. Personal solutions (Scott’s pi= .74) Healthy diet: Consuming less food, consuming healthy food. Physically activities: More exercise and physical activities. Medical treatments: Medications (e.g., diet pills), surgical treatments of obesity (e.g., gastric bypass, gastric stapling). Others: E.g., working with a support group, talking to a counselor, parents as role models. Societal causes (Scott’s pi= .86) The food industry: Obesity-promoting foods (fast=junk food), super-sizing, large increase in fast=junk food restaurants, other aggressive marketing promotions. Schools & education: Unhealthy foods in school cafeterias, lack of physical activity programs at schools, lack of public education about healthy eating and lifestyle. Socioeconomic factors: Low-income families may not be able to afford healthy food, exercise equipment, or a gym membership. They may be too busy to prepare their own healthy food. Others: E.g., automobile-oriented society (e.g., drive-thru stores and restaurants, big-box stores), unsafe community (crime, traffic, accident), and limited opportunities for outdoor activities. Societal solutions (Scott’s pi= .81) Regulations of the food industry: Regulating obesity-promoting foods, super-sizing, vending machines, and other aggressive marketing promotions, taxing unhealthy food. Changes in schools & education: Healthier food in school cafeteria, more physical activity programs at schools, more public education. Socioeconomic changes: Narrowing income gap, healthy food should be more affordable and available, more affordable exercise. Others: E.g., less automobile-oriented and more walking-oriented society (less drive-thru stores and restaurants, less big-box stores), safer community, and more opportunities for outdoor activities. Information on Stefanik-Sidener, 2013 Author: Kelsey Stefanik-Sidener Health topic: Diabetes Research questions: What was the dominant frame used in news stories about diabetes? What were the most common cause and solution frames used for each type of diabetes? Object of analysis: Diabetes coverage in the New York Times (N = 239) Time frame of analysis: 2000 to 2010 Info about variables Variables: The articles were coded for the presence of three types of frames for both causes of and solutions to diabetes, respectively: behavioral, societal, or medical, frames were not mutually exclusive Level of analysis: News article General cause frame (Krippendorff’s Alpha= .96) General solution frame (Krippendorff’s Alpha= .64) Behavioral causal frame Poor diet, lack of physical activity, or other individual-level issues Personal solutions Improving one’s diet or increasing activity levels Societal cause frames Poor food environments, car-centered culture, poor nutrition in schools, or other broad problems Societal solution frames Improving access to healthy foods, increasing nutrition education, or other public policy/societal-level solutions Medical cause frames Family history, genetics, age Medical solution frames Blood sugar control, medication, or surgery Information on Yoo & Kim, 2012 Authors: Jina H. Yoo, Junghyun Kim Health topic: obesity Research questions: What typifications (i.e., causal claims and solution claims) have been made in videos on YouTube with regard to the obesity issue? How do these typifications vary among different types of media formats on YouTube? Object of analysis: YouTube was searched with the keywords “obesity” and “obese” on 5 March 2010 and owing to capacity limits, the number of available videos was limited to 1,000 per each keyword; after a systematic random sampling and excluding irrelevant videos, total sample of N = 417 YouTube videos was analyzed Time frame of analysis: 2000 to 2010 Info about variables Variables: articles were coded for the presence of causal claims and solution typifications, behavioral, biological, and systematic causal factors on obesity being causal claims and behavioral solution, medical or pharmacological solution and systematic solution Reliability: Intercoder reliability was calculated for each category, and average intercoder reliability coefficient was .89. The Cohen’s kappa coefficient for each variable ranged between .77 and 1.00 Level of analysis: each whole video, including all of the video’s visual, audio, and text presentation Causal claims for obesity Solution typifications for obesity Behavioral causal claim Obesity is due to the individual’s lifestyle choices, including lack of exercise, wrong diet, lack of willpower and self-control, etc. Behavioral solution Improving one’s diet or increasing activity levels Biological causal claim Obesity is due to genetic or hormonal problems Medical or pharmacological solution To use diet pills or have a gastric bypass surgery as a means of treating obesity. Systematic causal claim Obesity is based on environmental influences and policy choices, including detrimental practices of corporations and government, such as the fast food industry’s marketing practices, school cafeterias’ unhealthy foods, inadequate or inaccurate information about food and nutrition, etc. Systematic solution A societal level of obesity treatment, such as implementing obesity-related policies, banning fast food marketing, removing vending machines from school, etc. Information on Zhang & Jin, 2015 Authors: Yuan Zhang, Yan Jin Health topic: Depression Research question: Do cultural values and organizational restraints shape the responsibility frames for health issues? Object of analysis: US (n = 228) and Chinese (n = 224) newspaper coverage on depression, including New York Times and USA Today, Philadelphia Inquirer, Houston Chronicle, Star Tribune and Denver Post; Chinese newspapers were not further specified, except for People’s Daily and Beijing Daily Time frame of analysis: 2000 to 2012 Info about variables Variables: News framing of causal and problem-solving responsibilities was measured at individual and societal levels, with individual-level and society-level causes and solutions. Each cause and solution included four subcategories which were measured nominally as 0 (absent) or 1 (present). Reliability: For the US data, a pretest in which two coders both coded a randomly selected 10% of the sample yielded Pearson’s r of 0.737 (p < 0.001) for individual causes, 0.862 (p < 0.001) for societal causes, 0.790 (p < 0.001) for individual solutions, and 0.907 (p < 0.001) for societal solutions. For the Chinese data, a pretest in which two bilingual coders both coded a randomly selected 10% of the sample yielded Pearson’s r of 0.861 (p < 0.001) for individual causes, 0.893 (p < 0.001) for societal causes, 0.807 (p < 0.001) for individual solutions, and 0.899 (p < 0.001) Level of analysis: Article Variables & operational definitions: In the appendix References Gollust, S. E., & Lantz, P. M. (2009). Communicating population health: Print news media coverage of type 2 diabetes. Social Science & Medicine (1982), 69(7), 1091–1098. https://doi.org/10.1016/j.socscimed.2009.07.009 Kim, S.?H., & Willis, A. (2007). Talking about obesity: News framing of who is responsible for causing and fixing the problem. Journal of Health Communication, 12(4), 359–376. https://doi.org/10.1080/10810730701326051 O’Hara, S. K., & Smith, K. C. (2007). Presentation of eating disorders in the news media: What are the implications for patient diagnosis and treatment? Patient Education and Counseling, 68(1), 43–51. https://doi.org/10.1016/j.pec.2007.04.006 Stefanik-Sidener, K. (2013). Nature, nurture, or that fast food hamburger: Media framing of diabetes in the New York Times from 2000 to 2010. Health Communication, 28(4), 351–358. https://doi.org/10.1080/10410236.2012.688187 Yoo, J. H., & Kim, J. (2012). Obesity in the new media: a content analysis of obesity videos on YouTube. Health Communication, 27(1), 86–97. https://doi.org/10.1080/10410236.2011.569003 Zhang, Y., & Jin, Y. (2015). Who's responsible for depression? The Journal of International Communication, 21(2), 204–225. https://doi.org/10.1080/13216597.2015.1052532 Zhang, Y., & Jin, Y. (2015). Who's responsible for depression? Journal of International Communication, 21(2), 204–225.

The old “Is the glass half empty or half full?” question does more than just illustrate a person’s proclivity for pessimism or for optimism. It alerts us to the possibility that the same real world phenomena may be interpreted in entirely different ways, with very real consequences. It is this notion that I apply to the way fat sex and thin sex are conceptualised in the larger social consciousness. While sexual, romantic and/or intimate acts between people where at least one individual is fat (Fat Sex) are deemed atypical, abnormal, fetishistic and even abusive (Saguy qtd. in Swami & Tovee 90; Schur qtd. in Prohaska 271; Gailey 119), such encounters between able-bodied individuals who are thin or of average weight (Thin Sex) are deemed normal and desirable. I argue in this article that this discrepancy in how we label and treat fat and thin sexuality is unjustified because the two domains are more similar than distinct. Given their similarity we should treat similar aspects of both domains in the same way, i.e. either as normal, or as fetishistic based on relevant criteria rather than body size. I also argue that fat prejudice and thin privilege underlie this discrepancy in modern western society. I finally conclude that this causes significant personal and social harm to both fat and thin individuals.Fat Sex – The Fetishized NormalHanne Blank, in writing of her foray into publishing body positive material exploring fat sexuality, speaks of the need for spaces that acknowledge the vitality and diversity of fat sex; not in fetishistic and pornographic portrayals of Big Beautiful Women offering themselves up as an object of desire but reflecting the desires and sexual experiences of fat people themselves (10). If there are a 100 million people in America who are obese according to BMI standards, she argues, they represent a whole array of body sizes and a lot of sexual activity, which she describes as follows:Fat people have sex. Sweet, tender, luscious sex. Sweaty, feral, sheet-ripping sex. Shivery, jiggly, gasping sex. Sentimental, slow, face-cradling sex. Even as you read these words, there are fat people out there somewhere joyously getting their freak on. Not only that, but fat people are falling in love, having hook-ups, being crushed-out, putting on sexy lingerie, being the objects of other people’s lust, flirting, primping before hot dates, melting a little as they read romantic notes from their sweeties, seducing and being seduced, and having shuddering, toe-curling orgasms that are as big as they are. It’s only natural. (15)Such normalcy and diverse expression, however, is not usually portrayed in popular media, nor even in much scholarly research. Apart from body positive spaces carved out by the fat acceptance movement online and the research of fat studies scholars, which, contextualises fat sexuality as healthy and exciting, in “the majority of scholarship on this topic, fat women’s sexual behaviors are never the result of women’s agency, are always the result of their objectification, and are never healthy” (Prohaska 271).This interpretation of fat sexuality, the assumptions associated with it and the reinforcement of these attitudes have much to do with the pervasiveness of fat prejudice in society today. One study estimates that the prevalence of weight based discrimination in the US increased by 66% between 1996 and 2006 (Andreyeva, Puhl and Brownell) and is now comparable to gender and race based discrimination (Puhl, Andreyeva and Brownell). This is not an isolated trend. An anthropological study analysing the globalisation of notions of fat being unhealthy and a marker of personal and social failing suggests that we have on our hands a rapidly homogenising global stigma associated with fat (Brewis, Wutich and Rodriguez-Soto), a climate of discrimination leading many fat people to what Goffman describes as a spoiled identity (3).Negative stereotypes affecting fat sexuality are established and perpetuated through a process of discursive constraint (Cordell and Ronai 30-31). “’No man will ever love you,’ Weinstein’s grandmother informs her (Weinstein, prologue), simultaneously offering her a negative category to define herself by and trying to coerce her into losing weight – literally constraining the discourse that Weinstein may apply to herself.Discursive constraint is created not only by individuals reinforcing cultural mores but also by overt and covert messages embedded in social consciousness: “fat people are unattractive”, “fat is ugly”, “fat people are asexual”, “fat sex is a fetish”, “no normal person can be attracted to a fat person”. Portrayals of fat individuals in mainstream media consolidate these beliefs.One of the most loved fat characters of 1990s, Fat Monica from the sitcom Friends is gluttonous, ungainly (rolling around in a bean bag, jolting the sofa as she sits), undesirable (Chandler says to Ross, “I just don’t want to be stuck here all night with your fat sister!”), and desperate for sex, affection and approval from the opposite sex: “the comedic potential of Fat Monica is premised on an understanding that her body is deviant or outside the norm” (Gullage 181).In Shallow Hal, a film in which a shallow guy falls in love with the inner beauty of a fat girl, Hal (Jack Black) is shown to be attracted to Rosemary (Gwyneth Paltrow) only after he can no longer see her real fat body and her “inner beauty” is represented by a thin white blond girl. All the while, the movie draws laughs from the audience at the fat jokes and gags made at the expense of Paltrow’s character.Ashley Madison, a website for married people looking to have an affair, used the image of a scantily clad fat model in an advertisement with the tagline “Did your wife scare you last night?”, implying that infidelity is justified if you’re not attracted to your partner, and fatness precludes attraction. And a columnist from popular magazine Marie Claire wrote about Mike and Molly, a sitcom about two fat people in a relationship:Yes, I think I'd be grossed out if I had to watch two characters with rolls and rolls of fat kissing each other ... because I'd be grossed out if I had to watch them doing anything. (Kelly)It is the prevalence of these beliefs that I call the fetishisation of fat sexuality. When fat bodies are created as asexual and undesirable, it gives rise to the rhetoric that to be sexually attracted to a fat body is unnatural, therefore making any person who is attracted to a fat body a fetishist and the fat person themselves an object of fetish.The internalisation of these beliefs is not only something that actively harms the self-esteem, sexual agency & health and happiness of fat individuals (Satinsky et al.), but also those who are attracted to them. Those who internalise these beliefs about themselves may be unable to view themselves as sexual and engage with their own bodies in a pleasurable manner, or to view themselves as attractive, perhaps discounting any assertions to the contrary. In a study designed to investigate the relationship between body image and sexual health in women of size, one participant revealed:I’ve had my issues with T as far as um, believing that T is attracted to me…because of my weight, my size and the way I look. (Satinsky et al. 717)Another participant speaks of her experience masturbating and her discomfort at touching her own flesh, leading her to use a vibrator and not her hands:Like, I don’t, I don’t look down. I look at the ceiling and I try to – it’s almost like I’m trying to imagine that I was thinner. Like, imagine that my stomach was flatter or something like that, which sounds bizarre, but I guess that’s what I’m trying to do. (Satinsky et al. 719)Others stay in bad marriages because they believe they wouldn’t find anyone else (Joanisse and Synnott 55) or tolerate abuse because of their low self-esteem (Hester qtd. in Prohaska 271).Similarly, men who internalise these attitudes about fat find it easier to dehumanise and objectify fat women, believe that they’d be desperate for sex and hence an easy target for a sexual conquest, and are less deserving of consideration (Prohaska and Gailey 19).On the other hand, many men who find fat women attractive (Fat Admirers or FA’s) remain closeted because their desire is stigmatised. Many do not make their preference known to their peer group and families, nor do they publicly acknowledge the woman they are intimate with. Research suggests that FA’s draw the same amount of stigma for being with fat women and finding them attractive, as they would for themselves being fat (Goode qtd. in Prohaska and Gailey).I do not argue here that all fat individuals have spoiled identities or that all expressions of fat sexuality operate from a place of stigma and shame, but that fat sexuality exists within a wider social fabric of fat phobia, discrimination and stigmatisation. Fulfilling sexual experience must therefore be navigated within this framework. As noted, the fat acceptance movement, body positive spaces online, and fat studies scholarship help to normalise fat sexuality and function as tools for resisting stigma and fetishisation.Resisting Stigma: Creating Counter NarrativesGailey, in interviews with 36 fat-identified women, found that though 34 of them (94%) had ‘experienced a life of ridicule, body shame and numerous attempts to lose weight’ which had an adverse effect on their relationships and sex life, 26 of them reported a positive change after having ‘embodied the size acceptance ideology’ (Gailey 118).Recently, Kristin Chirico, employee of Buzzfeed, released first an article and then a video titled My Boyfriend Loves Fat Women about her relationship with her boyfriend who loves fat women, her own discomfort with her fatness and her journey in embracing size acceptance ideologies: I will let him enjoy the thing he loves without tearing it down. But more importantly, I will work to earn love from me, who is the person who will always play the hardest to get. I will flirt as hard as I can, and I will win myself back.Books such as Wann’s Fat!So?, Blank’s Big Big Love: A Sex and Relationships Guide for People of Size (and Those Who Love Them), Chastain’s Fat: The Owner’s Manual and her blog Dances with Fat, Tovar’s Hot and Heavy: Fierce Fat Girls on Life, Love and Fashion, as well as Substantia Jones’s fat photography project called The Adipositivity Project are some examples of fat activism, size acceptance and body positive spaces and resources. The description on Jones’s site reads:The Adipositivity Project aims to promote the acceptance of benign human size variation and encourage discussion of body politics, not by listing the merits of big people, or detailing examples of excellence (these things are easily seen all around us), but rather through a visual display of fat physicality. The sort that's normally unseen. When fat individuals create personal narratives to resist stigmatisation of fat sexuality they confront the conundrum of drawing the line between sexual empowerment and glorifying fat fetishism. To see one’s own and other fat bodies as sexual, normal and worthy of pleasure is one way to subvert this fetishism. One would also take seriously any sexual advances, seeing oneself as desirable. The line between normal expression of fat sexuality and the wide spread belief that fat sex is fetishistic is so blurred however, that it becomes difficult to differentiate between them, so it is common to ask if one is being sexual or being an object of fetish. There is also the tension between the heady sense of power in being a sexual agent, and the desire to be wanted for more than just being a fat body.Modern burlesque stage is one arena where fat bodies are being recreated as sexy and desirable, offering a unique resource to ‘fat performers and audience members who want to experience their bodies in new and affirming ways’. Because burlesque is an erotic dance form, fat women on the burlesque stage are marked as ‘sexual, without question or challenge’. The burlesque stage has a great capacity to be a space for transforming sexual identity and driving changes in audience attitudes, creating a powerful social environment that is contrary to mainstream conditions in society (Asbill 300).The founder and creative director of “Big Burlesque” and “Fat-Bottom Revue” the world’s first all-fat burlesque troupe, however, notes that when she started Big Burlesque there were a couple of “bigger” performers on the neo-burlesque circuit, but they did not specifically advocate fat liberation. ‘Fat dance is rare enough; fat exotic/erotic dance is pretty much unheard of outside of “fetish” acts that alienate rather than normalise fat bodies’ (McAllister 305).In another instance, Laura writes that to most men her weight is a problem or a fetish, constraining the potential in relationships. Speaking of BBW (Big Beautiful Women) and BHM (Big Handsome Men) websites that cater to Fat Admirers she writes:As I’ve scrolled through these sites, I’ve felt vindicated at seeing women my size as luscious pinups. But, after a while, I feel reduced to something less than a person: just a gartered thigh and the breast-flesh offered up in a corset. I want to be lusted after. I want to be wanted. But, more than this, I want to love, and be loved. I want everything that love confers: being touched, being valued and being seen.That sexual attraction might rely wholly or partly on physical attributes, however, is hardly unfamiliar, and is an increasing phenomenon in the wider culture and popular media. Of course, what counts there is being thin and maintaining the thin state!Thin Sex: The Normalised FetishUnlike the fat body, the thin body is created as beautiful, sexually attractive, successful and overwhelmingly the norm (van Amsterdam). Ours is a culture fixated on physical beauty and sex, both of which are situated in thin bodies. Sexiness is a social currency that buys popularity, social success, and increasingly wealth itself (Levy). Like fat sex, thin sex operates on the stage set by the wider cultural ideals of beauty and attractiveness and that of the burden of thin privilege. Where stigma situates fat sexuality to abnormality and fetish, thin sexuality has to deal with the pressures of conforming to and maintaining the thin state (vam Amsterdam).Thin individuals also deal with the sexualisation of their bodies, confronting the separation of their personhood from their sexuality, in a sexual objectification of women that has long been identified as harmful. Ramsey and Hoyt explore how being objectified in heterosexual relationships might be related to coercion within those relationships. Their evidence shows that women are routinely objectified, and that this objectification becomes part of the schema of how men relate to women. Such a schema results in a fracturing of women into body parts dissociated from their personhood , making it easier to engage in violence with, and feel less empathy for female partners (in cases of rape or sexual assault). (Ramsey and Hoyt) What is interesting here is the fact that though aspects of thin sexuality are recognised as fetishistic (objectification of women), thin sex is still considered normal.Thin Sex, Fat Sex and 50 Shades of OverlapThe normalisation of sexual objectification -- society for the most part being habituated to the fetishistic aspects of thin sex, can be contrasted with attitudes towards comparable aspects of fat sex. In particular, Feederism, is generally viewed within scholarly discourse (and public attitudes) as ‘a consensual activity, a fetish, a stigmatised behaviour, and abuse’ (Terry & Vassey, Hester, Bestard, Murray as qtd. in Prohaska 281). Prohaska argues that Feederism and Diet Culture are broadly similar phenomena that elicit tellingly opposing judgements. She reports that the culture of feederism (as analysed on online forums) is a mostly consensual activity, where the community vocally dissuades non-consensual activities and any methods that may cause bodily harm (268). It is mostly a community of people who discuss measures of gradual weight gain and support and encourage each other in those goals. This, she argues, is very similar in tone to what appears on weight loss websites and forums (269). She contends, however that despite these parallels ‘the same scrutiny is not given to those who are attempting to lose weight as is placed upon those who do not diet or who try to gain weight’ (269).She notes that whereas in judging feederism emphasis is on fringe behaviours, in evaluating diet culture the focus is on behaviours deemed normal and healthy while only disorders like anorexia, bulimia, and pill using are judged fringe behaviours. This disparity, she claims, is rooted in fat phobia and prejudice (270).In comparing the dating sections of feederism websites with mainstream dating sites she notes that here too the nature of ads is similar, with the only difference being that in mainstream sites the body size preference is assumed. People seeking relationships on both kinds of sites look for partners who are ‘caring, intelligent and funny’ and consider ‘mutual respect’ as key (270).This is similar to what was revealed in an article by Camille Dodero, who interviewed a number of men who identify as fat admirers and delved into the myths and realities of fat admiration. The article covers stories of stigma that FA’s have faced and continue to face because of their sexual preference, and also of internalised self-hatred that makes it difficult for fat women to take their advances seriously. The men also create BBW/BHM dating websites as more than a fetish club. They experience these online spaces as safe spaces where they can openly meet people they would be interested in just as one would on a normal/mainstream dating site. Even if most women fit the type that they are attracted to in such spaces, it does not mean that they would be attracted to all of those women, just as on match.com one would look over prospective candidates for dating and that process would include the way they look and everything else about that person.Attempting to clear up the misconception that loving fat women is a fetish, one of the interviewees says,“Steve, over there, has a type,” gesturing wanly at a stranger in a hockey jersey probably not named Steve. “I have a type, too. Mine’s just bigger. He may like skinny blondes with bangs and long legs. I like pear shapes with brown hair and green eyes. I have a type—it just happens to be fat.” Besides, people aren’t fetish objects, they’re people. “It’s not like having a thing for leather.” (Dodero 3)ConclusionAnalysis of the domains of thin and fat sex shows that both have people engaging in sexual activity and romantic and intimate relationships with each other. Both have a majority of individuals who enjoy consensual, fulfilling sex and relationships, however these practices and desires are celebrated in one domain and stigmatised in the other. Both domains also have a portion of the whole that objectifies relationship partners with immense potential for harm, whether this involves sexualisation and objectification and its related harms in thin sex, objectification of fat bodies in some BBW and BHM circles, and the fringes of feederism communities, or non-body size specific fetish acts that individuals from both domains engage in. Qualitatively, since both domains significantly overlap, it is difficult to find the justification for the fetishisation of one and the normativity of the other. It seems plausible that this can be accounted for by the privilege associated with thin bodies and the prejudice against fat.Our failure to acknowledge such fetishisation of normal fat sex and normalisation of the fetishistic aspects of thin sex creates huge potential for harm for both groups, for it not only causes the fragmentation of effort when it comes to addressing these issues but also allows for the rich vitality and diversity of “normal” fat sex to wallow in obscurity and stigma.References Andreyeva, Tatiana, Rebecca M. Puhl, and Kelly D. Brownell. "Changes in Perceived Weight Discrimination among Americans, 1995–1996 through 2004–2006." Obesity 16 (2008): 1129-1134.Asbill, D. Lacy. "'I’m Allowed to Be a Sexual Being': The Distinctive Social Conditions of the Fat Burlesque Stage." The Fat Studies Reader, eds. Sondra Solovay and Esther Rothblum. New York: New York UP, 2009. 299.Blank, Hanne. Big Big Love, Revised, A Sex and Relationship Guide for People of Size (and Those Who Love Them). New York: Celestial Arts, 2011.Bogart, Laura. Salon 4 Aug. 2014.Brewis, A.A., A. Wutich and I. Rodriguez-Soto. "Body Norms and Fat Stigma in Global Perspective." Current Anthropology 52 (2011): 269-276.Chirico, Kristin. My Boyfriend Loves Fat Women. 25 Feb. 2015.Cordell, Gina, and Carol Rambo Ronai. "Identity Management among Overweight Women: Narrative Resistance to Stigma." Interpreting Weight: The Social Management of Fatness and Thinness, eds. Jeffery Sobal and Donna Maurer. Transaction Publishers, 1999. 29-48. Dodero, Camille. Guys Who Like Fat Chicks. 4 May 2011.Prohaska, Ariane, and Jeannine A. Gailey. "Achieving Masculinity through Sexual Predation: The Case of Hogging." Journal of Gender Studies 19.1 (2010): 13-25.Gailey, Jeannine A. “Fat Shame to Fat Pride: Fat Women’s Sexual and Dating Experiences.” Fat Studies: An Interdisciplinary Journal of Body Weight and Society 1.1 (2012). Goffman, Erving. Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs, N.J: Prentice-Hall, 1963.Gullage, Amy. "Fat Monica, Fat Suits and Friends." Feminist Media Studies 14.2 (2012): 178-89. Jacqueline. "I'm The 'Scary' Model in That Awful Ashley Madison Ad." 11 July 2011. Online. 24 May 2015.Jones, Substantia. The Adipositivity Project. n.d. Kelly, M. "Should 'Fatties' Get a Room? (Even on TV?)" 2010.Levy, Ariel. "Raunch Culture." Female Chauvinist Pigs: Women and the Rise of Raunch Culture. New York: Free Press, 2005. 7-45.McAllister, Heather. "Embodying Fat Liberation." The Fat Studies Reader, eds. Sondra Solovay and Esther Rothblum. New York: New York UP, 2009. 305.Prohaska, Ariane. “Help Me Get Fat! Feederism as Communal Deviance on the Internet.” Deviant Behaviour 35.4 (2014). Puhl, Rebecca M., Tatiana Andreyeva, and Kelly Brownell. "Perceptions of Weight Discrimination: Prevalence and Comparison to Race and Gender Discrimination in America." International Journal of Obesity 32 (2008): 992-1000.Ramsey, Laura R., and Tiffany Hoyt. "The Object of Desire: How Being Objectified Creates Sexual Pressure for Women in Heterosexual Relationships." Psychology of Women Quarterly (2014): 1-20.Satinsky, Sonya, et al. "'Fat Girl Complex': A Preliminary Investigation of Sexual Health and Body Image in Women of Size." Culture, Health and Sexuality: An International Journal for Research, Intervention and Care 15.6 (2013): 710-25.Swami, Viren, and Martin J. Tovee. “Big Beautiful Women: The Body Size Preferences of Male Fat Admirers.” The Journal of Sex Research 46.1 (2009): 89-86.Joanisse, Leanne, and Anthony Synnott. "Fighting Back: Reactions and Resistance to the Stigma of Obesity." Interpreting Weight: The Social Management of Fatness and Thinness, eds. Jeffery Sobal and Donna Maurer. New York: First Transaction Printing, 2013. 49-73.Van Amsterdam, Noortje. "Big Fat Inequalities, Thin Privilege: An Intersectional Perspective on 'Body Size'." European Journal of Women's Studies 20.2 (2013): 155-69.Weinstein, Rebecca Jane. “Fat Sex: The Naked Truth”. EBook, 2012.

I have only ever owned one pig. It didn’t have a name, due as it was for the table. Just pu‘aka. But I liked feeding it; nothing from the household was wasted. I planned not to become attached. We were having a feast and a pig was the one essential requirement. The piglet came to us as a small creature with a curly tail. It would not even live an adult life, as the fully-grown local pig is a fatty beast with little meat. Pigs are mostly killed when partly grown, when the meat/fat ratio is at its optimum. The pig was one of the few animals to accompany Polynesians as they made the slow journey across the islands and oceans from Asia: pigs and chickens and dogs. The DNA of island pigs reveals details about the route taken that were previously hidden (Larsen et al.). Of these three animals, pigs assumed the most ceremonial importance. In Tonga, pigs often live an exalted life. They roam freely, finding food where they can. They wallow. Wherever there is a pool of mud, often alongside a road, there is a pig wallowing. Huge beasts emerge from their pools with dark mud lining their bellies as they waddle off, teats swinging, to another pleasure. Pig snouts are extraordinarily strong; with the strength of a pig behind them, they can dig holes, uproot crops, and generally wreak havoc. How many times have I chased them from my garden, despairing at the loss of precious vegetables I could get no other way? But they must forage. They are fed scraps, and coconut for protein, but often must fend for themselves. Despite the fact that many meet an early death, their lives seem so much more interesting than those lived by the anonymous residents of intensive piggeries in Australia, my homeland. When the time came for the pig to be sacrificed to the demands of the feast, two young Tongan men did the honours. They also cooked the pig on an open fire after skewering it on a pole. Their reward was the roasted sweetmeats. The ‘umu was filled with taro and cassava, yam and sweet potato, along with lū pulu and lū ika: tinned beef and fish cooked in taro leaves and coconut cream. In the first sitting, all those of high status—church ministers, college teachers, important villagers and pālangi like me—had the first pick of the food. Students from the college and lowly locals had the second. The few young men who remained knew it was their task to finish off all of the food. They set about this activity with intense dedication, paying particular attention to the carcass of the pig. By the end of the night, what was left of our little pig was a pile of bones, the skeleton taken apart at every joint. Not a scrap of anything edible remained. In the early 1980s, I went to live on a small island in the Kingdom of Tonga, where my partner was the Principal of an agricultural college, in the main training young men for working small hereditary mixed farms. Memories of that time and a recent visit inform this reflection on the contemporary Tongan diet and problems associated with it. The role of food in a culture is never a neutral issue. Neither is body size, and Tongans have traditionally favoured the large body as an indication of status (Pollock 58). Similarly the capacity to eat has been seen as positive. Many Tongans are larger than is healthy, with 84% of men and 93% of women “considered overweight or obese” (Kirk et al. 36). The rate of diabetes, 80% of it undiagnosed, has doubled since the 1970s to 15% of the adult population (Colagiuri et al. 1378). In the Tongan diaspora there are also high rates of so-called “metabolic syndrome,” leading to this tendency to diabetes and cardiovascular disease. In Auckland, for instance, Pacific Islanders are 2.5 times more likely to suffer from this condition (Gentles et al.). Its chief cause is not, however, genetic, but comes from “differences in obesity,” leading to a much higher incidence of cardiovascular disease and diabetes (Gentles et al.). Deaths from diabetes in Tonga are common. When a minister’s wife in the neighbouring village to mine died, everyone of status on the island attended the putu. Though her gangrenous foot could have been amputated, the family decided against this, and she soon died from the complications of her diabetes. On arrival at the putu, as well as offering gifts such as mats and tapa, participants lined up to pay very personal respects to the dead woman. This took the form of a kiss on her face. I had never touched a dead person before, let alone someone who had died of gangrene, but life in another culture requires many firsts. I bent down and kissed the dry, cold face of a woman who had suffered much before dying. Young men of the family pushed sand over the grave with their own hands as the rest of us stood around, waiting for the funeral food: pigs, yes, but also sweets made from flour and refined sugar. Diet and eating practices are informed by culture, but so are understandings of illness and its management. In a study conducted in New Zealand, sharp differences were seen between the Tongan diaspora and European patients with diabetes. Tongans were more likely “to perceive their diabetes as acute and cyclical in nature, uncontrollable, and caused by factors such as God’s will, pollution in the environment, and poor medical care in the past”, and this was associated “with poorer adherence to diet and medication taking” (Barnes et al. 1). This suggests that as well as being more likely to suffer from illnesses associated with diet and body size, Tongans may also be less likely to manage them, causing these diseases to be even more debilitating. When James Cook visited the Tongan group and naively named them the Friendly Islands, he was given the customary hospitality shown to one of obviously high status. He and his officers were fed regularly by their hosts, even though this must have put enormous pressure on the local food systems, in which later supply was often guaranteed by the imposition of tapu in order to preserve crops and animals. Further pressure was added by exchanges of hogs for nails (Beaglehole). Of course, while they were feeding him royally and entertaining his crew with wrestling matches and dances, the local chiefs of Ha‘apai were arguing about exactly when they were going to kill him. If it were by night, it would be hard to take the two ships. By day, it might be too obvious. They never could agree, and so he sailed off to meet his fate elsewhere (Martin 279-80). As a visitor of status, he was regularly fed pork, unlike most of the locals. Even now, in contemporary Tonga, pigs are killed to mark a special event, and are not eaten as everyday food by most people. That is one of the few things about the Tongan diet that has not changed since the Cook visits. Pigs are usually eaten on formal feasting occasions, such as after church on the Sabbath (which is rigorously kept by law), at weddings, funerals, state occasions or church conferences. During such conferences, village congregations compete with each other to provide the most lavish spreads, with feasting occurring three times a day for a week or more. Though each pola is spread with a range of local root crops, fish and seafood, and possibly beef or even horse, the pola is not complete unless there is at least one pig on it. Pigs are not commercially farmed in Tonga, so these pigs have been hand- and self-raised in and around villages, and are in short supply after these events. And, although feasts are a visible sign of tradition, they are the exception. Tongans are not suffering from metabolic syndrome because they consume too much pork; they are suffering because in everyday life traditional foods have been supplanted by imports. While a range of traditional foods is still eaten, they are not always the first choice. Some imported foods have become delicacies. Mutton flap is a case in point. Known as sipi (sheep), it is mostly fat and bone, and even when barbequed it retains most of its fat. It is even found on outer islands without refrigeration, because it can be transported frozen and eaten when it arrives, thawed. I remember once the local shopkeeper said she had something I might like. A leg of lamb was produced from under the counter, mistakenly packed in the flap box. The cut was so unfamiliar that nobody else had much use for it. The question of why it is possible to get sipi in Tonga and very difficult to get any other kind of fresh meat other than one’s own pigs or chickens raises the question of how Tonga’s big neighbours think of Pacific islands. Such islands are the recipients of Australian and New Zealand aid; they are also the recipients of their waste. It’s not uncommon to find out of date medications, banned agricultural chemicals, and food that is really unsuitable for human consumption. Often the only fresh and affordable meat is turkey tails, chicken backs, and mutton flap. From July 2006 to July 2007, New Zealand exported $73 million worth of sheep off-cuts to the Pacific (Edwardes & Frizelle). Australia and the US account for the supply of turkey tails. Not only are these products some of the few fresh meat sources available, they are also relatively inexpensive (Rosen et al.). These foods are so detrimental to the health of locals that importing them has been banned in Fiji and independent Samoa (Edwardes & Frizelle). The big nations around the Pacific have found a market for the meat by-products their own citizens will not eat. Local food sources have also been supplanted as a result of the high value placed on other foods, like rice, flour and sugar, which from the nineteenth century became associated with “civilisation and progress” (Pollock 233). To counter this, education programs have been undertaken in Tonga and elsewhere in the Pacific in order to promote traditional local foods. These have also sought to address the impact of high food imports on the trade balance (Pollock 232). Food choices are not just determined by preference, but also by cost and availability. Similarly, the Tonga Healthy Weight Loss Program ran during the late 1990s, but it was found that a lack of “availability of healthy low-cost food was a problem” to its success (Englberger et al. 147). In a recent study of Tongan food preferences, it was found that “in general, Tongans prefer healthier traditional, indigenously produced, foods”, but that they are not always available (Evans et al. 170). In the absence of a consistent supply of local protein sources, the often inferior but available imported sources become the default ingredient. Fish in particular are in short supply. Though many Tongans can still be seen harvesting the reef for seafood at low tide, there is no extensive fishing industry capable of providing for the population at large. Intensive farming of pigs has been considered—there was a model piggery on the college where I lived, complete with facilities for methane collection—but it has not been undertaken. Given the strongly ceremonial function of the pig, it would take a large shift in thinking for it to be considered an everyday food. The first cooked pig I encountered arrived at my house in a woven coconut leaf basket, surrounded by baked taro and yam. It was a small pig, given by a family too poor to hold the feast usually provided after church when it was their turn. Instead, they gave the food portion owed directly to the preacher. There’s a faded photo of me squatting on a cracked linoleum floor, examining the contents of the basket, and wondering what on earth I’m going to do with them. I soon learnt the first lesson of island life: food must be shared. With no refrigeration, no family of strapping youths, and no plans to eat the pig myself, it had to be given away to neighbours. It was that simple. Even watermelon went off within the day. In terms of eating, that small pig would have been better kept until a later day, when it reached optimum size, but each family’s obligation came around regularly, and had to be fulfilled. Feasting, and providing for feasting, was a duty, even a fatongia mamafa: a “heavy duty” among many duties, in which the pig was an object deeply “entangled” in all social relations (Thomas). A small pig was big enough to carry the weight of such obligations, even if it could not feed a crowd. Growing numbers of tourists to Tonga, often ignored benignly by their hosts, are keen to snap photos of grazing pigs. It is unusual enough for westerners to see pigs freely wandering, but what is more striking about some pigs on Tongatapu and ‘Eua is that they venture onto the reefs and mudflats at low tide, going after the rich marine pickings, just as their human counterparts do. The silhouette of a pig in the water as the tropical sun sinks behind, caught in a digital frame, it is a striking memory of a holiday in a place that remains largely uninterested in its tourist potential. While an influx of guests is seen by development consultants as the path to the nation’s economic future, Tongans bemusedly refuse to take this possibility seriously (Menzies). Despite a negative trade balance, partly caused by the importation of foreign food, Tonga survives on a combination of subsistence farming and remittances from Tongans living overseas; the tourist potential is largely unrealised. Dirk Spennemann’s work took a strange turn when, as an archaeologist working in Tonga, it became necessary for him to investigate whether these reef-grazing pigs were disturbing midden contents on Tongatapu. In order to establish this, he collected bags of both wet and dry “pig excreta” (107). Spenemann’s methodology involved soaking the contents of these bags for 48 hours, stirring them frequently; “they dissolved, producing considerable smell” (107). Spennemann concluded that pigs do appear to have been eating fish and shellfish, along with grass and “the occasional bit of paper” (107). They also feed on “seaweed and seagrass” (108). I wonder if these food groups have any noticeable impact on the taste of their flesh? Creatures fed particular diets in order to create a certain distinct taste are part of the culinary traditions of the world. The deli around the corner from where I live sells such gourmet items as part of its lunch fare: Saltbush lamb baguettes are one of their favourites. In the Orkneys, the rare and ancient North Ronaldsay Sheep are kept from inland foraging for most of the year by a high stone fence in order to conserve the grass for lambing time. This forces them to eat seaweed on the beach, producing a distinct marine taste, one that is highly valued in certain Parisian restaurants. As an economy largely cut out of the world economic loop, Tonga is unlikely to find select menus on which its reef pigs might appear. While living on ‘Eua, I regularly took a three hour ferry trip to Tongatapu in order to buy food I could not get on my home island. One of these items was wholemeal flour, from which I baked bread in a mud oven we had built outside. Bread was available on ‘Eua, but it was white, light and transported loose in the back of truck. I chose to make my own. The ferry trip usually involved a very rough crossing, though on calmer days, roof passengers would cook sipi on the diesel chimney, added flavour guaranteed. It usually only took about thirty minutes on the way out from Nafanua Harbour before the big waves struck. I could endure them for a while, but soon the waves, combined with a heavy smell of diesel, would have me heading for the rail. On one journey, I tried to hold off seasickness by focussing on an island off shore from Tongatapu. I went onto the front deck of the ferry and faced the full blast of the wind. With waves and wind, it was difficult to stand. I diligently stared at the island, which only occasionally disappeared beneath the swell, but I soon knew that this trip would be like the others; I’d be leaning over the rail as the ocean came up to meet me, not really caring if I went over. I could not bear to share the experience, so in many ways being alone on the foredeck was ideal for me, if I had to be on the boat at all. At least I thought I was alone, but I soon heard a grunt, and looked across to see an enormous sow, trotters tied front and back, lying across the opposite side of the boat. And like me, she too was succumbing to her nausea. Despite the almost complete self-absorption seasickness brings, we looked at each other. I may have imagined an acknowledgement, but I think not. While the status of pigs in Tongan life remains important, in many respects the imposition of European institutions and the availability of imported foods have had an enormous impact on the rest of the Tongan diet, with devastating effects on the health of Tongans. Instead of the customary two slow-cooked meals, one before noon and one in the evening (Pollock 56), consisting mostly of roots crops, plantains and breadfruit, with a relish of meat or fish, most Tongans eat three meals a day in order to fit in with school and work schedules. In current Tongan life, there is no time for an ‘umu every day; instead, quick and often cheaper imported foods are consumed, though local foods can also be cooked relatively quickly. While some still start the day by grabbing a piece of left over cassava, many more would sit down to the ubiquitous Pacific breakfast food: crackers, topped with a slab of butter. Food is a neo-colonial issue. If larger nations stopped dumping unwanted and nutritionally poor food products, health outcomes might improve. Similarly, the Tongan government could tip the food choice balance by actively supporting a local and traditional food supply in order to make it as cheap and accessible as the imported foods that are doing such harm to the health of Tongans References Barnes, Lucy, Rona Moss-Morris, and Mele Kaufusi. “Illness Beliefs and Adherence in Diabetes Mellitus: A Comparison between Tongan and European Patients.” The New Zealand Medical Journal 117.1188 (2004): 1-9. Beaglehole, J.C. Ed. The Journals of Captain James Cook on his Voyages of Discovery: The Voyage of the Resolution and Discovery 1776-1780. Parts I & II. Cambridge: Hakluyt Society, 1967. ­­­____. Ed. The Journals of Captain James Cook on his Voyages of Discovery: The Voyage of the Resolution and Adventure 1772-1775. Cambridge: Hakluyt Society, 1969. Colagiuri, Stephen, Ruth Colgaiuri, Siva Na‘ati, Soana Muimuiheata, Zafirul Hussein, and Taniela Palu. “The Prevalence of Diabetes in the Kingdom of Tonga.” Diabetes Care 28.2 (2002): 1378-83. Edwardes, Brennan, and Frank Frizelle. “Globalisation and its Impact on the South Pacific.” The New Zealand Medical Journal 122.1291 (2009). 4 Aug. 2010 Englberger, L., V. Halavatau, Y. Yasuda, & R, Yamazaki. “The Tonga Healthy Weight Loss Program.” Asia Pacific Journal of Clinical Nutrition 8.2 (1999): 142-48. Gentles, Dudley, et al. “Metabolic Syndrome Prevalence in a Multicultural Population in Auckland, New Zealand.” Journal of the New Zealand Medical Association 120.1248 (2007). 4 Aug. 2010 Kirk, Sara F.L., Andrew J. Cockbain, and James Beasley. “Obesity in Tonga: A cross-sectional comparative study of perceptions of body size and beliefs about obesity in lay people and nurses.” Obesity Research & Clinical Practice 2.1 (2008): 35-41. Larsen, Gregor, et al. “Phylogeny and Ancient DNA of Sus Provides New Insights into Neolithic Expansion in Island Southeast Asia and Oceania.” Proceedings of the National Academy of Sciences of the United States of America 104.12 (2007): 4834-39. Martin, John. Tonga Islands: William Mariner’s Account, 1817. Neiafu, Tonga: Vava‘u, 1981. Menzies, Isa. “Cultural Tourism and International Development in Tonga: Notes from the Field”. Unpublished paper. Oceanic Passages Conference. Hobart, June 2010. Pollock, Nancy J. These Roots Remain: Food Habits in Islands of the Central and Eastern Pacific since Western Contact. Honolulu: Institute for Polynesian Studies, 1992. Rosen, Rochelle K., Judith DePue, and Stephen T. McGarvey. “Overweight and Diabetes in American Samoa: The Cultural Translation of Research into Health Care Practice.” Medicine and Health/ Rhode Island 91.12 (2008): 372-78. Spennemann, Dirk H.R. “On the Diet of Pigs Foraging on the Mud Flats of Tongatapu: An Investigation in Taphonomy.” Archaeology in New Zealand 37.2 (1994): 104-10. Thomas, Nicholas. Entangled Objects: Exchange, Material Objects and Colonialism in the Pacific. Cambridge, Massachusetts: Harvard UP, 1991.

Introduction This paper offers a survey of familiar popular music performers and songwriters who reference coffee in their work. It examines three areas of discourse: the psychoactive effects of caffeine, coffee and courtship rituals, and the politics of coffee consumption. I claim that coffee carries a cultural and musicological significance comparable to that of the chemical stimulants and consumer goods more readily associated with popular music. Songs about coffee may not be as potent as those featuring drugs and alcohol (Primack; Schapiro), or as common as those referencing commodities like clothes and cars (Englis; McCracken), but they do feature across a wide range of genres, some of which enjoy archetypal associations with this beverage. m.o.m.m.y. Needs c.o.f.f.e.e.: The Psychoactive Effect of Coffee The act of performing and listening to popular music involves psychological elements comparable to the overwhelming sensory experience of drug taking: altered perceptions, repetitive grooves, improvisation, self-expression, and psychological empathy—such as that between musician and audience (Curry). Most popular music genres are, as a result, culturally and sociologically identified with the consumption of at least one mind-altering substance (Lyttle; Primack; Schapiro). While the analysis of lyrics referring to this theme has hitherto focused on illegal drugs and alcoholic beverages (Cooper), coffee and its psychoactive ingredient caffeine have been almost entirely overlooked (Summer). The most recent study of drugs in popular music, for example, defined substance use as “tobacco, alcohol, marijuana, cocaine and other stimulants, heroin and other opiates, hallucinogens, inhalants, prescription drugs, over-the-counter drugs, and nonspecific substances” (Primack 172), thereby ignoring a chemical stimulant consumed by 90 per cent of adult Americans every day (Lovett). The wide availability of coffee and the comparatively mild effect of caffeine means that its consumption rarely causes harm. One researcher has described it as a ubiquitous and unobtrusive “generalised public activity […] ‘invisible’ to analysts seeking distinctive social events” (Cooper 92). Coffee may provide only a relatively mild “buzz”—but it is now accepted that caffeine is an addictive substance (Juliano) and, due to its universal legality, coffee is also the world’s most extensively traded and enthusiastically consumed psychoactive consumer product (Juliano 1). The musical genre of jazz has a longstanding relationship with marijuana and narcotics (Curry; Singer; Tolson; Winick). Unsurprisingly, given its Round Midnight connotations, jazz standards also celebrate the restorative impact of coffee. Exemplary compositions include Burke/Webster’s insomniac torch song Black Coffee, which provided hits for Sarah Vaughan (1949), Ella Fitzgerald (1953), and Peggy Lee (1960); and Frank Sinatra’s recordings of Hilliard/Dick’s The Coffee Song (1946, 1960), which satirised the coffee surplus in Brazil at a time when this nation enjoyed a near monopoly on production. Sinatra joked that this ubiquitous drink was that country’s only means of liquid refreshment, in a refrain that has since become a headline writer’s phrasal template: “There’s an Awful Lot of Coffee in Vietnam,” “An Awful Lot of Coffee in the Bin,” and “There’s an Awful Lot of Taxes in Brazil.” Ethnographer Aaron Fox has shown how country music gives expression to the lived social experience of blue-collar and agrarian workers (Real 29). Coffee’s role in energising working class America (Cooper) is featured in such recordings as Dolly Parton’s Nine To Five (1980), which describes her morning routine using a memorable “kitchen/cup of ambition” rhyme, and Don't Forget the Coffee Billy Joe (1973) by Tom T. Hall which laments the hardship of unemployment, hunger, cold, and lack of healthcare. Country music’s “tired truck driver” is the most enduring blue-collar trope celebrating coffee’s analeptic powers. Versions include Truck Drivin' Man by Buck Owens (1964), host of the country TV show Hee Haw and pioneer of the Bakersfield sound, and Driving My Life Away from pop-country crossover star Eddie Rabbitt (1980). Both feature characteristically gendered stereotypes of male truck drivers pushing on through the night with the help of a truck stop waitress who has fuelled them with caffeine. Johnny Cash’s A Cup of Coffee (1966), recorded at the nadir of his addiction to pills and alcohol, has an incoherent improvised lyric on this subject; while Jerry Reed even prescribed amphetamines to keep drivers awake in Caffein [sic], Nicotine, Benzedrine (And Wish Me Luck) (1980). Doye O’Dell’s Diesel Smoke, Dangerous Curves (1952) is the archetypal “truck drivin’ country” song and the most exciting track of its type. It subsequently became a hit for the doyen of the subgenre, Red Simpson (1966). An exhausted driver, having spent the night with a woman whose name he cannot now recall, is fighting fatigue and wrestling his hot-rod low-loader around hairpin mountain curves in an attempt to rendezvous with a pretty truck stop waitress. The song’s palpable energy comes from its frenetic guitar picking and the danger implicit in trailing a heavy load downhill while falling asleep at the wheel. Tommy Faile’s Phantom 309, a hit for Red Sovine (1967) that was later covered by Tom Waits (Big Joe and the Phantom 309, 1975), elevates the “tired truck driver” narrative to gothic literary form. Reflecting country music’s moral code of citizenship and its culture of performative storytelling (Fox, Real 23), it tells of a drenched and exhausted young hitchhiker picked up by Big Joe—the driver of a handsome eighteen-wheeler. On arriving at a truck stop, Joe drops the traveller off, giving him money for a restorative coffee. The diner falls silent as the hitchhiker orders up his “cup of mud”. Big Joe, it transpires, is a phantom trucker. After running off the road to avoid a school bus, his distinctive ghost rig now only reappears to rescue stranded travellers. Punk rock, a genre closely associated with recreational amphetamines (McNeil 76, 87), also features a number of caffeine-as-stimulant songs. Californian punk band, Descendents, identified caffeine as their drug of choice in two 1996 releases, Coffee Mug and Kids on Coffee. These songs describe chugging the drink with much the same relish and energy that others might pull at the neck of a beer bottle, and vividly compare the effects of the drug to the intense rush of speed. The host of “New Music News” (a segment of MTV’s 120 Minutes) references this correlation in 1986 while introducing the band’s video—in which they literally bounce off the walls: “You know, while everybody is cracking down on crack, what about that most respectable of toxic substances or stimulants, the good old cup of coffee? That is the preferred high, actually, of California’s own Descendents—it is also the subject of their brand new video” (“New Music News”). Descendents’s Sessions EP (1997) featured an overflowing cup of coffee on the sleeve, while punk’s caffeine-as-amphetamine trope is also promulgated by Hellbender (Caffeinated 1996), Lagwagon (Mr. Coffee 1997), and Regatta 69 (Addicted to Coffee 2005). Coffee in the Morning and Kisses in the Night: Coffee and Courtship Coffee as romantic metaphor in song corroborates the findings of early researchers who examined courtship rituals in popular music. Donald Horton’s 1957 study found that hit songs codified the socially constructed self-image and limited life expectations of young people during the 1950s by depicting conservative, idealised, and traditional relationship scenarios. He summarised these as initial courtship, honeymoon period, uncertainty, and parting (570-4). Eleven years after this landmark analysis, James Carey replicated Horton’s method. His results revealed that pop lyrics had become more realistic and less bound by convention during the 1960s. They incorporated a wider variety of discourse including the temporariness of romantic commitment, the importance of individual autonomy in relationships, more liberal attitudes, and increasingly unconventional courtship behaviours (725). Socially conservative coffee songs include Coffee in the Morning and Kisses in the Night by The Boswell Sisters (1933) in which the protagonist swears fidelity to her partner on condition that this desire is expressed strictly in the appropriate social context of marriage. It encapsulates the restrictions Horton identified on courtship discourse in popular song prior to the arrival of rock and roll. The Henderson/DeSylva/Brown composition You're the Cream in My Coffee, recorded by Annette Hanshaw (1928) and by Nat King Cole (1946), also celebrates the social ideal of monogamous devotion. The persistence of such idealised traditional themes continued into the 1960s. American pop singer Don Cherry had a hit with Then You Can Tell Me Goodbye (1962) that used coffee as a metaphor for undying and everlasting love. Otis Redding’s version of Butler/Thomas/Walker’s Cigarettes and Coffee (1966)—arguably soul music’s exemplary romantic coffee song—carries a similar message as a couple proclaim their devotion in a late night conversation over coffee. Like much of the Stax catalogue, Cigarettes and Coffee, has a distinctly “down home” feel and timbre. The lovers are simply content with each other; they don’t need “cream” or “sugar.” Horton found 1950s blues and R&B lyrics much more sexually explicit than pop songs (567). Dawson (1994) subsequently characterised black popular music as a distinct public sphere, and Squires (2002) argued that it displayed elements of what she defined as “enclave” and “counterpublic” traits. Lawson (2010) has argued that marginalised and/or subversive blues artists offered a form of countercultural resistance against prevailing social norms. Indeed, several blues and R&B coffee songs disregard established courtship ideals and associate the product with non-normative and even transgressive relationship circumstances—including infidelity, divorce, and domestic violence. Lightnin’ Hopkins’s Coffee Blues (1950) references child neglect and spousal abuse, while the narrative of Muddy Waters’s scorching Iodine in my Coffee (1952) tells of an attempted poisoning by his Waters’s partner. In 40 Cups of Coffee (1953) Ella Mae Morse is waiting for her husband to return home, fuelling her anger and anxiety with caffeine. This song does eventually comply with traditional courtship ideals: when her lover eventually returns home at five in the morning, he is greeted with a relieved kiss. In Keep That Coffee Hot (1955), Scatman Crothers supplies a counterpoint to Morse’s late-night-abandonment narrative, asking his partner to keep his favourite drink warm during his adulterous absence. Brook Benton’s Another Cup of Coffee (1964) expresses acute feelings of regret and loneliness after a failed relationship. More obliquely, in Coffee Blues (1966) Mississippi John Hurt sings affectionately about his favourite brand, a “lovin’ spoonful” of Maxwell House. In this, he bequeathed the moniker of folk-rock band The Lovin’ Spoonful, whose hits included Do You Believe in Magic (1965) and Summer in the City (1966). However, an alternative reading of Hurt’s lyric suggests that this particular phrase is a metaphorical device proclaiming the author’s sexual potency. Hurt’s “lovin’ spoonful” may actually be a portion of his seminal emission. In the 1950s, Horton identified country as particularly “doleful” (570), and coffee provides a common metaphor for failed romance in a genre dominated by “metanarratives of loss and desire” (Fox, Jukebox 54). Claude Gray’s I'll Have Another Cup of Coffee (Then I’ll Go) (1961) tells of a protagonist delivering child support payments according to his divorce lawyer’s instructions. The couple share late night coffee as their children sleep through the conversation. This song was subsequently recorded by seventeen-year-old Bob Marley (One Cup of Coffee, 1962) under the pseudonym Bobby Martell, a decade prior to his breakthrough as an international reggae star. Marley’s youngest son Damian has also performed the track while, interestingly in the context of this discussion, his older sibling Rohan co-founded Marley Coffee, an organic farm in the Jamaican Blue Mountains. Following Carey’s demonstration of mainstream pop’s increasingly realistic depiction of courtship behaviours during the 1960s, songwriters continued to draw on coffee as a metaphor for failed romance. In Carly Simon’s You’re So Vain (1972), she dreams of clouds in her coffee while contemplating an ostentatious ex-lover. Squeeze’s Black Coffee In Bed (1982) uses a coffee stain metaphor to describe the end of what appears to be yet another dead-end relationship for the protagonist. Sarah Harmer’s Coffee Stain (1998) expands on this device by reworking the familiar “lipstick on your collar” trope, while Sexsmith & Kerr’s duet Raindrops in my Coffee (2005) superimposes teardrops in coffee and raindrops on the pavement with compelling effect. Kate Bush’s Coffee Homeground (1978) provides the most extreme narrative of relationship breakdown: the true story of Cora Henrietta Crippin’s poisoning. Researchers who replicated Horton’s and Carey’s methodology in the late 1970s (Bridges; Denisoff) were surprised to find their results dominated by traditional courtship ideals. The new liberal values unearthed by Carey in the late 1960s simply failed to materialise in subsequent decades. In this context, it is interesting to observe how romantic coffee songs in contemporary soul and jazz continue to disavow the post-1960s trend towards realistic social narratives, adopting instead a conspicuously consumerist outlook accompanied by smooth musical timbres. This phenomenon possibly betrays the influence of contemporary coffee advertising. From the 1980s, television commercials have sought to establish coffee as a desirable high end product, enjoyed by bohemian lovers in a conspicuously up-market environment (Werder). All Saints’s Black Coffee (2000) and Lebrado’s Coffee (2006) identify strongly with the culture industry’s image of coffee as a luxurious beverage whose consumption signifies prominent social status. All Saints’s promotional video is set in a opulent location (although its visuals emphasise the lyric’s romantic disharmony), while Natalie Cole’s Coffee Time (2008) might have been itself written as a commercial. Busting Up a Starbucks: The Politics of Coffee Politics and coffee meet most palpably at the coffee shop. This conjunction has a well-documented history beginning with the establishment of coffee houses in Europe and the birth of the public sphere (Habermas; Love; Pincus). The first popular songs to reference coffee shops include Jaybird Coleman’s Coffee Grinder Blues (1930), which boasts of skills that precede the contemporary notion of a barista by four decades; and Let's Have Another Cup of Coffee (1932) from Irving Berlin’s depression-era musical Face The Music, where the protagonists decide to stay in a restaurant drinking coffee and eating pie until the economy improves. Coffee in a Cardboard Cup (1971) from the Broadway musical 70 Girls 70 is an unambiguous condemnation of consumerism, however, it was written, recorded and produced a generation before Starbucks’ aggressive expansion and rapid dominance of the coffee house market during the 1990s. The growth of this company caused significant criticism and protest against what seemed to be a ruthless homogenising force that sought to overwhelm local competition (Holt; Thomson). In response, Starbucks has sought to be defined as a more responsive and interactive brand that encourages “glocalisation” (de Larios; Thompson). Koller, however, has characterised glocalisation as the manipulative fabrication of an “imagined community”—whose heterogeneity is in fact maintained by the aesthetics and purchasing choices of consumers who make distinctive and conscious anti-brand statements (114). Neat Capitalism is a more useful concept here, one that intercedes between corporate ideology and postmodern cultural logic, where such notions as community relations and customer satisfaction are deliberately and perhaps somewhat cynically conflated with the goal of profit maximisation (Rojek). As the world’s largest chain of coffee houses with over 19,400 stores in March 2012 (Loxcel), Starbucks is an exemplar of this phenomenon. Their apparent commitment to environmental stewardship, community relations, and ethical sourcing is outlined in the company’s annual “Global Responsibility Report” (Vimac). It is also demonstrated in their engagement with charitable and environmental non-governmental organisations such as Fairtrade and Co-operative for Assistance and Relief Everywhere (CARE). By emphasising this, Starbucks are able to interpellate (that is, “call forth”, “summon”, or “hail” in Althusserian terms) those consumers who value environmental protection, social justice and ethical business practices (Rojek 117). Bob Dylan and Sheryl Crow provide interesting case studies of the persuasive cultural influence evoked by Neat Capitalism. Dylan’s 1962 song Talkin’ New York satirised his formative experiences as an impoverished performer in Greenwich Village’s coffee houses. In 1995, however, his decision to distribute the Bob Dylan: Live At The Gaslight 1962 CD exclusively via Starbucks generated significant media controversy. Prominent commentators expressed their disapproval (Wilson Harris) and HMV Canada withdrew Dylan’s product from their shelves (Lynskey). Despite this, the success of this and other projects resulted in the launch of Starbucks’s in-house record company, Hear Music, which released entirely new recordings from major artists such as Ray Charles, Paul McCartney, Joni Mitchell, Carly Simon and Elvis Costello—although the company has recently announced a restructuring of their involvement in this venture (O’Neil). Sheryl Crow disparaged her former life as a waitress in Coffee Shop (1995), a song recorded for her second album. “Yes, I was a waitress. I was a waitress not so long ago; then I won a Grammy” she affirmed in a YouTube clip of a live performance from the same year. More recently, however, Crow has become an avowed self-proclaimed “Starbucks groupie” (Tickle), releasing an Artist’s Choice (2003) compilation album exclusively via Hear Music and performing at the company’s 2010 Annual Shareholders’s Meeting. Songs voicing more unequivocal dissatisfaction with Starbucks’s particular variant of Neat Capitalism include Busting Up a Starbucks (Mike Doughty, 2005), and Starbucks Takes All My Money (KJ-52, 2008). The most successful of these is undoubtedly Ron Sexsmith’s Jazz at the Bookstore (2006). Sexsmith bemoans the irony of intense original blues artists such as Leadbelly being drowned out by the cacophony of coffee grinding machines while customers queue up to purchase expensive coffees whose names they can’t pronounce. In this, he juxtaposes the progressive patina of corporate culture against the circumstances of African-American labour conditions in the deep South, the shocking incongruity of which eventually cause the old bluesman to turn in his grave. Fredric Jameson may have good reason to lament the depthless a-historical pastiche of postmodern popular culture, but this is no “nostalgia film”: Sexsmith articulates an artfully framed set of subtle, sensitive, and carefully contextualised observations. Songs about coffee also intersect with politics via lyrics that play on the mid-brown colour of the beverage, by employing it as a metaphor for the sociological meta-narratives of acculturation and assimilation. First popularised in Israel Zangwill’s 1905 stage play, The Melting Pot, this term is more commonly associated with Americanisation rather than miscegenation in the United States—a nuanced distinction that British band Blue Mink failed to grasp with their memorable invocation of “coffee-coloured people” in Melting Pot (1969). Re-titled in the US as People Are Together (Mickey Murray, 1970) the song was considered too extreme for mainstream radio airplay (Thompson). Ike and Tina Turner’s Black Coffee (1972) provided a more accomplished articulation of coffee as a signifier of racial identity; first by associating it with the history of slavery and the post-Civil Rights discourse of African-American autonomy, then by celebrating its role as an energising force for African-American workers seeking economic self-determination. Anyone familiar with the re-casting of black popular music in an industry dominated by Caucasian interests and aesthetics (Cashmore; Garofalo) will be unsurprised to find British super-group Humble Pie’s (1973) version of this song more recognisable. Conclusion Coffee-flavoured popular songs celebrate the stimulant effects of caffeine, provide metaphors for courtship rituals, and offer critiques of Neat Capitalism. Harold Love and Guthrie Ramsey have each argued (from different perspectives) that the cultural micro-narratives of small social groups allow us to identify important “ethnographic truths” (Ramsey 22). Aesthetically satisfying and intellectually stimulating coffee songs are found where these micro-narratives intersect with the ethnographic truths of coffee culture. 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