The influence of patient and doctor gender on diagnosing coronary heart disease

Using novel methods, this paper explores sources of uncertainty and gender bias in primary care doctors' diagnostic decision-making about coronary heart disease (CHD). Claims about gendered consultation styles and quality of care are re-examined, along with the adequacy of CHD models for women. Randomly selected doctors in the UK and the US (n=112, 56 per country, stratified by gender) were shown standardised videotaped vignettes of actors portraying patients with CHD. Patients' age, gender, ethnicity and social class were varied systematically. During interviews, doctors gave free-recall accounts of their decision-making, which were analysed to determine patient and doctor gender effects. We found differences in male and female doctors' responses to different types of patient information. Female doctors recall more patient cues overall, particularly about history presentation, and particularly amongst women. Male doctors appear less affected by patient gender but both male and especially female doctors take more account of male patients' age, and consider more age-related disease possibilities for men than women. Findings highlight the need for better integration of knowledge about female presentations within accepted CHD risk models, and do not support the contention that women receive better-quality care from female doctors.

The grip of personalization in adult social care:between managerial domination and fantasy

This paper examines the 'ideological grip' of personalization. It does so empirically, tracking the trajectory of personalization through austerity budgeting in one English local authority. In this case, personalization continued to signify hope and liberation even though the most draconian cuts in the Council's history effectively rendered personalization a practical impossibility. This requires critical theorization. Two bodies of theory are interrogated. First Boltanski's sociology of critique, and, in particular, his notion of managerial domination illuminate the way in which change imperatives and crises come to cement ideological formations. Here it is argued that the articulation of personalization with transformation lends itself to managerial domination. It is further argued, though, that while institutional actors may be able to manipulate the symbolic to evade, what Boltanski terms, deconstructionist critique, this cannot entirely explain the hold of this particular discourse. Here, the Lacanian concept of enjoyment is deployed to interrogate its extra-symbolic function and fantasmatic form. Finally, the paper explores the political implications of such affective attachment and, in particular, the guarantee that personalization offers in a period of welfare state decline. © The Author(s) 2012.

A weakly-supervised Bayesian model for violence detection from social media

Social streams have proven to be the mostup-to-date and inclusive information on cur-rent events. In this paper we propose a novelprobabilistic modelling framework, called violence detection model (VDM), which enables the identification of text containing violent content and extraction of violence-related topics over social media data. The proposed VDM model does not require any labeled corpora for training, instead, it only needs the in-corporation of word prior knowledge which captures whether a word indicates violence or not. We propose a novel approach of deriving word prior knowledge using the relative entropy measurement of words based on the in-tuition that low entropy words are indicative of semantically coherent topics and therefore more informative, while high entropy words indicates words whose usage is more topical diverse and therefore less informative. Our proposed VDM model has been evaluated on the TREC Microblog 2011 dataset to identify topics related to violence. Experimental results show that deriving word priors using our proposed relative entropy method is more effective than the widely-used information gain method. Moreover, VDM gives higher violence classification results and produces more coherent violence-related topics compared toa few competitive baselines.

'Listen to my madness':understanding the experiences of people with serious mental illness

This article explores the salience of disability theory for understanding the experiences of people with serious mental illness. Drawing on data from a focus group study, we suggest that users experience both impairment (as embodied irrationality) which can, in itself, be oppressive, and also have to manage their lives within a largely disabling society. We outline some of the strategies adopted by users to manage their situation and ensure they access and receive health services, and illustrate how these are a result of the complex relationship between disability and impairment. We suggest that using a framework of the social model of disability provides a useful way of understanding and making sense of the experience of users with serious mental illness. © Blackwell Publishing Ltd/Foundation for the Sociology of Health & Illness 2005.

Interactive data in financial reporting:the construction of the non-professional investor

The Securities and Exchange Commission (SEC) in the United States and in particular its immediately past chairman, Christopher Cox, has been actively promoting an upgrade of the EDGAR system of disseminating filings. The new generation of information provision has been dubbed by Chairman Cox, "Interactive Data" (SEC, 2006). In October this year the Office of Interactive Disclosure was created(http://www.sec.gov/news/press/2007/2007-213.htm). The focus of this paper is to examine the way in which the non-professional investor has been constructed by various actors. We examine the manner in which Interactive Data has been sold as the panacea for financial market 'irregularities' by the SEC and others. The academic literature shows almost no evidence of researching non-professional investors in any real sense (Young, 2006). Both this literature and the behaviour of representatives of institutions such as the SEC and FSA appears to find it convenient to construct this class of investor in a particular form and to speak for them. We theorise the activities of the SEC and its chairman in particular over a period of about three years, both following and prior to the 'credit crunch'. Our approach is to examine a selection of the policy documents released by the SEC and other interested parties and the statements made by some of the policy makers and regulators central to the programme to advance the socio-technical project that is constituted by Interactive Data. We adopt insights from ANT and more particularly the sociology of translation (Callon, 1986; Latour, 1987, 2005; Law, 1996, 2002; Law & Singleton, 2005) to show how individuals and regulators have acted as spokespersons for this malleable class of investor. We theorise the processes of accountability to investors and others and in so doing reveal the regulatory bodies taking the regulated for granted. The possible implications of technological developments in digital reporting have been identified also by the CEO's of the six biggest audit firms in a discussion document on the role of accounting information and audit in the future of global capital markets (DiPiazza et al., 2006). The potential for digital reporting enabled through XBRL to "revolutionize the entire company reporting model" (p.16) is discussed and they conclude that the new model "should be driven by the wants of investors and other users of company information,..." (p.17; emphasis in the original). Here rather than examine the somewhat illusive and vexing question of whether adding interactive functionality to 'traditional' reports can achieve the benefits claimed for nonprofessional investors we wish to consider the rhetorical and discursive moves in which the SEC and others have engaged to present such developments as providing clearer reporting and accountability standards and serving the interests of this constructed and largely unknown group - the non-professional investor.

Sexuality and Christianity:understanding the attitudes and negotiations of young adults in the UK

Christianity has historically incorporated numerous strands of thinking on sexuality; in some cases, problematizing sexuality through the endorsement of celibacy and asceticism while at other historical and contextual moments, marriage and procreation become ideals (Price 2006). Contemporary Christians negotiate many sexual scripts (including ‘secular’ ones), but ‘appropriate’ Christian sexuality is still usually defined in terms of monogamy, the containment of sex within marriage, and heterosexuality. This chapter will explore the attitudes, beliefs and practices toward sexuality of young Christian women and men aged between 18 and 25 and living in the UK, based on a qualitative and quantitative research project entitled Religion, Youth and Sexuality: A Multi-faith Exploration, which utilized questionnaires, in-depth interviews and video diaries. The chapter will consider the variations in attitude between young people from different Christian denominations in relation to three themes: sex outside of marriage, celibacy and monogamy.

24-Karat or fool’s gold? Consequences of real team and co-acting group membership in healthcare organizations

Although theory on team membership is emerging, limited empirical attention has been paid to the effects of different types of team membership on outcomes. We propose that an important but overlooked distinction is that between membership of real teams and membership of co-acting groups, with the former being characterized by members who report that their teams have shared objectives, and structural interdependence and engage in team reflexivity. We hypothesize that real team membership will be associated with more positive individual- and organizational-level outcomes. These predictions were tested in the English National Health Service, using data from 62,733 respondents from 147 acute hospitals. The results revealed that individuals reporting the characteristics of real team membership, in comparison with those reporting the characteristics of co-acting group membership, witnessed fewer errors and incidents, experienced fewer work related injuries and illness, were less likely to be victims of violence and harassment, and were less likely to intend to leave their current employment. At the organizational level, hospitals with higher proportions of staff reporting the characteristics of real team membership had lower levels of patient mortality and sickness absence. The results suggest the need to clearly delineate real team membership in order to advance scientific understanding of the processes and outcomes of organizational teamwork.

Biologising parenting:neuroscience discourse, English social and public health policy and understandings of the child

In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However, what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this article illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.

Lexico-grammatical portraits of vulnerable women in war:the 1641 depositions

The 1641 Depositions are testimonies collected from (mainly Protestant) witnesses documenting their experiences of the Irish uprising that began in October 1641. As news spread across Europe of the events unfolding in Ireland, reports of violence against women became central to the ideological construction of the barbarism of the Catholic rebels. Against a backdrop of women's subordination and firmly defined gender roles, this article investigates the representation of women in the Depositions, creating what we have termed "lexico-grammatical portraits" of particular categories of woman. In line with other research dealing with discursive constructions in seventeenth-century texts, a corpus-assisted discourse analytical approach is taken. Adopting the assumptions of Critical Discourse Analysis, the discussion is extended to what the findings reveal about representations of the roles of women, both in the reported events and in relation to the dehumanisation of the enemy in atrocity propaganda more generally. © John Benjamins Publishing Company.

Biologising parenting:neuroscience discourse, English social and public health policy and understandings of the child

In recent years, claims about children's developing brains have become central to the formation of child health and welfare policies in England. While these policies assert that they are based on neuro-scientific discoveries, their relationship to neuroscience itself has been debated. However what is clear is that they portray a particular understanding of children and childhood, one that is marked by a lack of acknowledgment of child personhood. Using an analysis of key government-commissioned reports and additional advocacy documents, this chapter illustrates the ways that the mind of the child is reduced to the brain, and this brain comes to represent the child. It is argued that a highly reductionist and limiting construction of the child is produced, alongside the idea that parenting is the main factor in child development. It is concluded that this focus on children's brains, with its accompanying deterministic perspective on parenting, overlooks children's embodied lives and this has implications for the design of children's health and welfare services.

Violence against women in Ethiopia

Investigating the experience of violence against women and exploring women's coping strategies is a crucial component of re-tailoring the provision of services for victims/survivors. This article explores violence against women in the context of culture, theory of fear of violence and literature on spaces perceived to be 'safe' or 'dangerous' by women victims/survivors of violence in Ethiopia. To collect the relevant data, we conducted 14 semi-structured interviews with Ethiopian women who are victims/survivors of violence and three interviews with gender experts in Ethiopia. Our group of women suffer in 'silence' and confide only in friends and relatives. They did not resort to institutional support due to lack of awareness and general societal disapproval of such measures. This contrasts with claims by experts that the needs of these women are addressed using an institutional approach. Culture, migration status and lack of negotiating power in places of work are key factors when considering violence. The majority of the respondents in this study occupy both public and private spaces such as bars and homes and have experienced violence in those spaces. The social relations and subsequent offences they endured do not make spaces such as these safe. Education of both sexes, creation of awareness, sustainable resource allocation to support victims/survivors, ratification of the Maputo protocol and effective law enforcement institutions are some of the practical strategies we propose to mitigate the incidence of violence in Ethiopia. © 2010 Taylor & Francis.

The regulatory environment of the section of the non-standardized goods market - The findings of an interview research on Hungarian construction industry small enterprises

In this paper the behavior of economic actors shown in the uncertain quality goods markets is examined from the perspective of the sociology of markets. The analysis uses the findings of in-depth interviews conducted in 2011 and 2012 respectively amongst small and medium size entrepreneurs working in construction industry. In the Hungarian construction industry neither formal rules, nor vocational chambers, are able to create a safe environment for entrepreneurs. Nevertheless, networks created as a result of micro-selection steps might be able to enforce the quality of services, observe deadlines and what is more, ensure payment discipline. In this market, the typical high risk can be reduced by relationships. Networks reduce also the cost of transactions, since the important part of the services in this field could only be standardized at significant costs.

General and special education teachers' knowledge of and attitudes toward students with HIV/AIDS

AIDS education is mandated in schools throughout the United States to educate students about the disease. Teachers are expected to assume the major role of disseminating this information; therefore it is reasonable to question how knowledgeable teachers are about HIV/AIDS and where their information is coming from. This study explored the knowledge and attitudes of general and special education teachers toward students with HIV/AIDS and investigated whether a relationship between knowledge and attitudes existed. Information was collected using the AIDS Knowledge and Attitude Survey (AKAS). The sample was limited to certified teachers resulting in 318 participants.^ Research questions were analyzed using descriptive statistics, frequencies, t-tests, one-way analysis of variance (ANOVA), Scheffe post hoc analysis, and Pearson Product-Moment Correlation. Results indicated that general and special education teachers did not have complete knowledge about HIV/AIDS. Participants were knowledgeable regarding modes of transmission which may be the area of greatest concern for teachers, however, deficiencies were present within teachers' knowledge of general statements and facts and pathology. Among the ten demographic variables analyzed, six (gender, race/ethnicity, level of education, certification, instructional level taught, and classroom AIDS instruction) contained statistical significance.^ Analysis of attitudes indicated that general and special education teachers' overall attitudes toward students with HIV/AIDS were generally positive within clusters of Instruction and Fear, but not within Sensitivity and Communication. Among the ten demographic variables used for analysis only three (age, graduate enrollment status, and classroom AIDS instruction) produced statistical significance. Results found statistically significant relationships between Total Knowledge, all knowledge subtests, Fear, and Overall Attitudes. Statistical significance was also located on Total Knowledge, Pathology and Transmission knowledge subtests, and Sensitivity, as well as between Pathology and Instruction, and General Statements and Facts and Communication.^ The only variable determined to have statistical significance on both knowledge and attitudes was classroom AIDS instruction. Participants with previous AIDS instruction showed greater knowledge and possessed more positive attitudes. A review of previous research indicated training to be effective in increasing knowledge and fostering more favorable behavior toward persons with AIDS. Therefore, this study finds AIDS training to be beneficial for all teachers and is recommended during preservice education or through inservices for teachers already in the field. ^

Sexual harassment of Miami-Dade County Public School students by school personnel

The purpose of this research was to assess the type and extent of sexual harassment of Miami-Dade County Public School (M-DCPS) students by school employees. In addition, the school system's existing procedures for handling such harassment were investigated, including students' awareness of and willingness to follow such procedures.^ Over 500 seniors from fourteen high schools around the county completed surveys which asked them to indicate whether or not they had received training on the topic of sexual harassment, whether or not they were aware of their school's policy on sexual harassment, whether or not they would feel comfortable reporting an incident of sexual harassment, whether or not they had experienced various forms of sexual harassment, and if they had been harassed, whether or not they reported the incident to a school official.^ Results indicated that sexual harassment of M-DCPS students by school employees is widespread, and the procedures that are currently in place to deal with this harassment are ineffective. Sixty-eight percent (68%) of the sample population indicated that a school employee had sexually harassed them; however, only four percent (4%) reported the incident to a school official. Responses indicated that this discrepancy exists because few students have received any training, few are aware of their schools' policies, and few are comfortable with the existing reporting procedures. ^

An investigation into factors that influence the sense of competence of six high school girls

The purpose of this study was to explore the influence of environment, behavior, capabilities, beliefs and values, and identity, based on Dilts' (1990) levels of cognitive alignment, on the cognitive construct of sense of competence and related constructs of self-efficacy, motivation, expectations, and goal-setting among adolescent girls. An individual who is aligned is free from conflict among the interaction of these levels. In addition, academic achievement, adolescent culture, parental involvement, and school environment were four of several issues in the lives of adolescent girls examined to explore how these issues might interact with the levels of alignment and sense of competence.^ A case study approach used in-depth interviews with six female seniors from private single-sex and mixed-sex high schools organized around the levels of alignment and school environment. Response patterns were analyzed to determine each girl's varying evidence of alignment or freedom from conflict within her environment.^ The findings indicated that none of the girls were able to meet the conditions for alignment in Dilts' model or a sense of competence. School environment, parental involvement, and adolescent culture were important factors influencing the extent to which conflict was experienced by each girl. The girls with domain-specific successes developed strategies that concentrated their efforts in the domains in which they could demonstrate their best abilities. The results contribute to current theory and research on adolescent girls: and have value for practitioners working with adolescent girls in developing strategies to improve their self-efficacy, motivation, expectations, goal-setting, and overall sense of competence. ^