Emotions and identity in the figured world of becoming a doctor

CONTEXT: There is little room in clerkship curricula for students to express emotions, particularly those associated with the development of a caring identity. Yet it is recognised that competence, alone, does not make a good doctor. We therefore set out to explore the relationship between emotions and identity in clerkship education. Our exploration was conceptually oriented towards Figured Worlds theory, which is linked to Bakhtin's theory of dialogism.

METHODS: Nine female and one male member of a mixed student cohort kept audio-diaries and participated in both semi-structured and cognitive individual interviews. The researchers identified 43 emotionally salient utterances in the dataset and subjected them to critical discourse analysis. They applied Figured Worlds constructs to within-case and cross-case analyses, supporting one another's reflexivity and openness to different interpretations, and constantly comparing their evolving interpretation against the complete set of transcripts.

RESULTS: Students' emotions were closely related to their identity development in the world of medicine. Patients were disempowered by their illnesses. Doctors were powerful because they could treat those illnesses. Students expressed positive emotions when they were granted positions in the world of medicine and were able to identify with the figures of doctors or other health professionals. They identified with doctors who behaved in caring and professionally appropriate ways towards patients and supportively towards students. Students expressed negative emotions when they were unable to develop their identities.

CONCLUSIONS: Critical discourse analysis has uncovered a link between students' emotions and their identity development in the powerful world of becoming and being a doctor. At present, identity development, emotions and power are mostly tacit in undergraduate clinical curricula. We speculate that helping students to express emotions and exercise power in the most effective ways might help them to develop caring identities.

Handling uncertainty in a medical study of dietary intake during pregnancy

This paper is concerned with handling uncertainty as part of the analysis of data from a medical study. The study is investigating connections between the birth weight of babies and the dietary intake of their mothers. Bayesian belief networks were used in the analysis. Their perceived benefits include (i) an ability to represent the evidence emerging from the evolving study, dealing effectively with the inherent uncertainty involved; (ii) providing a way of representing evidence graphically to facilitate analysis and communication with clinicians; (iii) helping in the exploration of the data to reveal undiscovered knowledge; and (iv) providing a means of developing an expert system application.

A Syntax-based approach to measuring the degree of inconsistency for belief bases

Measuring the degree of inconsistency of a belief base is an important issue in many real world applications. It has been increasingly recognized that deriving syntax sensitive inconsistency measures for a belief base from its minimal inconsistent subsets is a natural way forward. Most of the current proposals along this line do not take the impact of the size of each minimal inconsistent subset into account. However, as illustrated by the well-known Lottery Paradox, as the size of a minimal inconsistent subset increases, the degree of its inconsistency decreases. Another lack in current studies in this area is about the role of free formulas of a belief base in measuring the degree of inconsistency. This has not yet been characterized well. Adding free formulas to a belief base can enlarge the set of consistent subsets of that base. However, consistent subsets of a belief base also have an impact on the syntax sensitive normalized measures of the degree of inconsistency, the reason for this is that each consistent subset can be considered as a distinctive plausible perspective reflected by that belief base,whilst eachminimal inconsistent subset projects a distinctive viewof the inconsistency. To address these two issues,we propose a normalized framework formeasuring the degree of inconsistency of a belief base which unifies the impact of both consistent subsets and minimal inconsistent subsets. We also show that this normalized framework satisfies all the properties deemed necessary by common consent to characterize an intuitively satisfactory measure of the degree of inconsistency for belief bases. Finally, we use a simple but explanatory example in equirements engineering to illustrate the application of the normalized framework.

Government decisions before and during the First World War and the living standards in Germany during a drastic natural experiment

The First World War hit Germany severely, particularly the agricultural sector, because the outbreak came unexpected and its duration exceeded all expectations. Many resources necessary for agricultural production were required by the war economy and led to shortages and shrinking supplies. Many agricultural laborers were drafted and the blockade imposed by the allies prevented Germany from a great deal of imports. As a consequence, the nutritional situation was devastating, particularly after 1916, and hit all groups of the German society. The period under observation provides one of most drastic natural experiments in the 20th century. This study uses anthropometric data from German soldiers who served in the Second World War to trace living standards between the 1900s and the 1920s. In contrast to other approaches, this paper is able to distinguish between social groups by occupation, religious denominatio\n, regional origin, and city size. The results suggest that although all social strata were hit by famine conditions, the height of farmers, urban citizens, Catholics, and especially individuals born in the highly integrated food-import regions along the coast and the banks of the Rhine declined most.

Globalization and the State in Contemporary Crime Fiction:A World of Crime

Why has crime fiction become a global genre? How do writers use crime fiction to reflect upon the changing nature of crime and policing in our contemporary world? This book argues that the globalization of crime fiction should not be celebrated uncritically. Instead, it looks at the new forms and techniques writers are using to examine the crimes and policing practices that define a rapidly changing world. In doing so, this collection of essays examines how the relationship between global crime, capitalism, and policing produces new configurations of violence in crime fiction – and asks whether the genre can find ways of analyzing and even opposing such violence as part of its necessarily limited search for justice both within and beyond the state.

Prevalence of early and late age-related macular degeneration in a rural population in Northern India: The INDEYE Feasibility Study

PURPOSE. To assess the prevalence of age-related macular degeneration (AMD) in a rural population in Northern India. METHODS. In a pilot feasibility study, 1443 people (median age, 60 years; 52% women), were identified from enumeration of the 50+ age group in 11 randomly sampled villages from a rural, periurban district of Haryana, Northern India. Of those identified, 87% attended an eye examination that included digital fundus photography. Fundus images were graded at a single reading center using definitions from the Wisconsin Age-Related Maculopathy Grading System. RESULTS. Fundus photographs were available for 1101 participants. Overall, 28.8% of participants had ungradable fundus images due to cataract. Including all with ungradable images in the denominator, the prevalence of soft drusen was 34.0% (95% confidence interval [CI] 26.1–42.9); of soft indistinct drusen, 2.2% (95% CI, 1.1–4.4); and of pigmentary irregularities, 10.8% (95% CI, 7.1–16.1). There were 15 (1.4%) cases of late-stage AMD (95% CI, 0.8–2.3) with the prevalence rising from 0.4% in the 50- to 59-year age range to 4.6% in those aged 70 years or older. CONCLUSIONS. Drusen and pigmentary irregularities are common among the rural northern Indian population. The prevalence of late AMD is similar to that encountered in Western settings and is likely to contribute significantly to the burden of vision loss in older people in the developing world.

Distance and Proximity in Service to the Empire: Ulster and New Zealand between the Wars

This essay uses the concepts of ‘distance’ and ‘proximity’ to investigate and assess perceptions of community, nation and empire in inter-war New Zealand and Ulster (as well as Ireland and Northern Ireland) within a British imperial context, and explores the extent to which service of the empire (for example in the First World War) promoted both notions of imperial unity and local autonomy. It focuses on how these perceptions were articulated in the inter-war years during visits to Northern Ireland by three New Zealand premiers – Massey, Forbes and Coates – and to New Zealand by the Prime Minister of Northern Ireland, Lord Craigavon. It discusses the significant ways in which distance from their ‘home base’ and proximity to expatriate communities (in Craigavon's case) and Irish unionists and nationalists (in the case of the New Zealand premiers) inflected public statements during their visits. By examining these inter-war visits and investigating the rhetoric used and the cultural demonstrations associated with them, the factors of both distance and proximity can be used to evaluate similarities and difference across two parts of the empire. Thus, we can throw some light on the nature and dynamics of British imperial identity in the early twentieth century.

Capital substitutability and weak sustainability revisited: The conditions for capital substitution in the presence of risk

The capital approach is frequently used to model sustainability. A development is deemed to be sustainable when capital is not reduced. There are different definitions of sustainability, based on whether or not they allow that different forms of capital may be substituted for each other. A development that allows for the substitution of different forms of capital is called weakly sustainable. This article shows that in a risky world and a risk-averse society even under the assumptions of weak sustainability the circumstances under which different forms of capital may be substituted are limited. This is due to the risk-reducing effect of diversification. Using Modern Portfolio Theory this article shows under which conditions substitution of different forms of capital increases risk for future generations.

Choose Life not Economic Growth: Critical Social Theory for People, Planet and Flourishing in the ‘Age of Nature’

Choose a fucking big television Choose washing machines, cars, compact disc players, and electrical tin openers... Choose leisure wear and matching luggage. Choose a three piece suite on hire purchase in a range of fucking fabrics. Choose DIY and wondering who you are on a Sunday morning. Choose sitting on that couch watching mind-numbing sprit-crushing game shows Stuffing fucking junk food into your mouth. Choose your future. Choose life. (Irvine Welsh, Trainspotting, 1996) Anyone who believes exponential growth can go on forever in a finite world is either a madman or an economist (Kenneth Boulding)