Rules of Order: Or So to Speak

How members of a social unit acquire their shared knowledge about the social world was approached in Sherif\u27s (1935, 1936) writings on norm formation and in the phenomenological descriptions of Schutz (1971, 1973) and Berger and Luckmann (1967). Both traditions presume that shared understandings originate in face-to-face encounters, but they diverge in that the phenomenologists argue that talk, and the construction of typifications, plays a prominent role in the acquisition of shared knowledge. For the phenomenologists, a typification enables members to categorize behavior as a known event and permits individuals to consider disparate behaviors as belonging to the same class of events. Furthermore, types are presumed to be known to, and useable by, any other member of the social unit even though the details of the original encounter are masked by the typification. The research reported here is an attempt to explore the formation of types, and examine the role that everyday conversation may have in the construction of shared understandings. By varying how members come to acquire their knowledge about the social world–through direct participation or through the words and deeds of others–a series of four studies was conducted. The first part of each study always begins in the same manner: participants are requested to judge how far in front of the screen a figure from a Julesz stereogram appears to be. The later part of each study always has one member who continues to see, or has been told about, the extended figure while (s)he interacts with a partner who views, unbeknownst to the other, a recessed figure. The task to be solved remains the same as that in the first part: to reach a decision about extension. This alteration in perspective was to provide a challenge to the knowledge formed during the first part of the encounter and to make visible any taken-for-granted assumptions that may have been acquired. Contrary to expectations, in the majority of the interactions, 60.71%, the alteration in perspective was never uncovered. An analysis of the members\u27 talk revealed that during the first part of the study the participants constructed a vocabulary and exchanged a set of expressions with each other that took the meaning and reference of those terms for granted. As there was no challenge to this usage, in the later parts of the study the partner who saw or was told about an extended figure continued to presume that these words can be re-used unproblematically, and the task was presented to the partner with a vocabulary that masked the exact reference of the expressions. With this vagueness as to reference, the individual who saw recession used the meaning of these words to describe the recessed display (s)he saw and successfully concealed the disparity. It is argued that these expressions presumed useable by any other be considered typifications. By examining what is concealed and by understanding the role talk plays in this masking, the issue of what members are presumed to share is addressed. As the notion of sharedness is also at the heart of the concept of norm, some of the implications of this examination for the concept of norm are examined

Mortality Trends and Disparities Among Racial/Ethnic and Sex Subgroups in New York City, 1990 to 2000

New York City census data for 1990 and 2000 for all-cause and disease-specific mortality adjusted by age were examined by race/ethnicity. Primary cause of death was coded as HIV/AIDS, cardiovascular disease, coronary heart disease, acute myocardial infarction, stroke, diabetes, or cancer. For White, Black, Hispanic and Asian groups, relative mortality ratios (RMR) were derived for 2000 relative to 1990. Ratios of RMR’s for minority groups were derived relative to Whites. From 1990 to 2000, HIV, cancer, CVD, CHD, AMI, and stroke-related mortality decreased. Decreases in HIV-related mortality were notably less for minority males. Diabetes mortality rates rose dramatically, with Hispanic and Asian males having notably greater increases than White males. Increases in mortality among Asians exceeded those of other groups, and appear to correspond with increased immigration/acculturation. Mortality shifts among different diseases and racial groups should alert public health officials to consider immigration patterns in designing, implementing, and evaluating interventions to prevent disease-related mortality, with a goal to eliminate disparitie

The Impact of Mental Illness Status on the Length of Jail Detention and the Legal Mechanism of Jail Release

Objective: This analysis investigated whether persons with serious mental illnesses have longer jail detentions than other detainees and whether they are released by different legal mechanisms. Methods: Jail records and mental health service records from a Medicaid database were matched for all admissions to the Philadelphia jail system in 2003. Survival analysis techniques were used to compare length of jail stays of persons with and without serious mental illnesses (N=24,290). Serious mental illness was defined as a diagnosis either in the schizophrenia spectrum (DSM-IV code 295.XX) or of a major affective disorder (DSMIV code 296.XX) recorded in Medicaid records (2001–2003). Mechanisms of release were also examined for those with release dates before September 1, 2005 (N=20,573) Results: Just over 50% of the 1,457 persons with serious mental illnesses were released from jail within 30 days of incarceration, compared with 56% of the other detainees. Mental illness status was not found to be a significant predictor of longer detentions. Forty-nine percent of those with serious mental illnesses were released from jails through unpredictable release mechanisms, such as bail, release from court, or withdrawal of a bench warrant, whereas only 19% were released through mechanisms that had release dates that allowed adequate time for discharge planning. Conclusions: The findings suggest that reentry programs and other jail-based interventions for persons with mental illnesses should ensure that they have the capacity to rapidly identify and serve clients with shorter and more unpredictable stays or risk not being responsive to the needs of a substantial proportion of this population

Developing Common Metrics for the Clinical and Translational Science Awards (CTSAs): Lessons Learned.

The National Institutes of Health (NIH) Roadmap for Medical Research initiative, funded by the NIH Common Fund and offered through the Clinical and Translational Science Award (CTSA) program, developed more than 60 unique models for achieving the NIH goal of accelerating discoveries toward better public health. The variety of these models enabled participating academic centers to experiment with different approaches to fit their research environment.A central challenge related to the diversity of approaches is the ability to determine the success and contribution of each model. This paper describes the effort by the Evaluation Key Function Committee to develop and test a methodology for identifying a set of common metrics to assess the efficiency of clinical research processes and for pilot testing these processes for collecting and analyzing metrics. The project involved more than one-fourth of all CTSAs and resulted in useful information regarding the challenges in developing common metrics, the complexity and costs of acquiring data for the metrics, and limitations on the utility of the metrics in assessing clinical research performance. The results of this process led to the identification of lessons learned and recommendations for development and use of common metrics to evaluate the CTSA effort

Health Status of HIV-Infected Women Entering Care: Baseline Medical Findings from the Women of Color Initiative

The WOC Initiative is a prospective study of 921 women of color (WOC) entering HIV care at nine (three rural, six urban) sites across the US. A baseline interview was performed that included self-reported limitation(s) in activity, health conditions, and the CDC's health-related quality of life measures (Healthy Days). One-third of the WOC reported limiting an activity because of illness or a health condition and those with an activity limitation reported 13 physically and 14 mentally unhealthy days/month, compared with 5 physically and 9 mentally unhealthy days/month in the absence of an activity limitation. Age was associated with a three- to fourfold increased risk of an activity limitation but only for WOC in the urban sites. Diabetes was associated with a threefold increased risk of a limitation among women at rural sites. Cardiac disease was associated with a six- to sevenfold increased risk of an activity limitation for both urban and rural WOC. HIV+ WOC reported more physically and mentally unhealthy days than the general US female population even without an activity limitation. Prevention and treatment of diabetes and cardiovascular disease will need to be a standard part of HIV care to promote the long-term health and HRQOL for HIV-infected WOC

Baseline Social Characteristics and Barriers to Care from a Special Projects of National Significance Women of Color with HIV Study: A Comparison of Urban and Rural Women and Barriers to HIV Care

We describe the baseline sociodemographic characteristics of the Health Resources and Services Administration's Special Programs of National Significance Women of Color (WOC) Initiative. Between November 2010 and July 2013, 921 WOC were prospectively enrolled in HIV medical care at nine sites, six urban (N=641) and three rural sites (N=280) across the US. We describe the study sample, drawing comparisons between urban and rural sites on sociodemographics, barriers to HIV care, HIV care status at study entry, substance use and sexual risk factors, and the relationship among these variables. Urban sites' participants differed from rural sites on all sociodemographic variables except age (median=42.3). Women at urban sites were more likely to be Hispanic, less educated, single, living alone, unstably housed, unemployed, and to have reported lower income. More urban women were transferring care to HIV care or had been lost to care. Urban women reported more barriers to care, many relating to stigma or fatalism about HIV care. Urban women reported more substance use and sexual risk behaviors. A better understanding of how HIV care is embedded in communities or fragmented across many sites in urban areas may help understand barriers to long-term engagement in HIV care encountered by WOC

Adequation of the open source Geographical Information System QGIS to the brazilian public

The QGIS open source software comprises storing, organization, processing, integration and analysis of geospatial data. This article aims to present the consolidation of portability process of the open source geoprocessing software QGIS for the brazilian public, through the project “Adequation of the Computational Application QGIS, a Geographic Information System to the Brazilian Public”. The results of the project, which is still in progress, indicates an increase in the numbers of users of QGIS, search in websites, exchange of information in virtual groups and interaction in social networks. These results are mainly achieved by maintaining the translation of QGIS and promoting other divulgation methods. The continuity of this actions will allow even more users to have access to this open source geoprocessing tool

Utility of the AAMCʼs Graduation Questionnaire to Study Behavioral and Social Sciences Domains in Undergraduate Medical Education

The Institute of Medicine (IOM) report on social and behavioral sciences (SBS) indicated that 50% of morbidity and mortality in the United States is associated with SBS factors, which the report also found were inadequately taught in medical school. A multischool collaborative explored whether the Association of American Medical Colleges Graduation Questionnaire (GQ) could be used to study changes in the six SBS domains identified in the IOM report

Health Newscasts for Increasing Influenza Vaccination Coverage: An Inductive Reasoning Game Approach

Both pandemic and seasonal influenza are receiving more attention from mass media than ever before. Topics such as epidemic severity and vaccination are changing the way in which we perceive the utility of disease prevention. Voluntary influenza vaccination has been recently modeled using inductive reasoning games. It has thus been found that severe epidemics may occur because individuals do not vaccinate and, instead, attempt to benefit from the immunity of their peers. Such epidemics could be prevented by voluntary vaccination if incentives were offered. However, a key assumption has been that individuals make vaccination decisions based on whether there was an epidemic each influenza season; no other epidemiological information is available to them. In this work, we relax this assumption and investigate the consequences of making more informed vaccination decisions while no incentives are offered. We obtain three major results. First, individuals will not cooperate enough to constantly prevent influenza epidemics through voluntary vaccination no matter how much they learned about influenza epidemiology. Second, broadcasting epidemiological information richer than whether an epidemic occurred may stabilize the vaccination coverage and suppress severe influenza epidemics. Third, the stable vaccination coverage follows the trend of the perceived benefit of vaccination. However, increasing the amount of epidemiological information released to the public may either increase or decrease the perceived benefit of vaccination. We discuss three scenarios where individuals know, in addition to whether there was an epidemic, (i) the incidence, (ii) the vaccination coverage and (iii) both the incidence and the vaccination coverage, every influenza season. We show that broadcasting both the incidence and the vaccination coverage could yield either better or worse vaccination coverage than broadcasting each piece of information on its own