Surgical Identity Play: The Anatomy Lab Revisited

The anatomy lab has been studied by sociologists interested in professional socialization since the 1950s. This is because the act of dissecting a cadaver is thought to be foundational for both the student's medical knowledge and the development of the student's professional identity. In this paper, I revisit the anatomy lab both historically and ethnographically. Drawing on theoretical insights from the laboratory ethnography tradition within science and technology studies, I show that students use material artifacts in the lab to support their “surgical identity play.” This activity is structured by the laboratory's performative architecture even while it is unsupervised by anatomy faculty. While many analyses of professional socialization focus on how students learn to interact with patients during their training, I show that the anatomy lab experience is an important form of professional socialization because here students learn to employ surgical instruments, language, and dress, and begin to relate to each other as colleagues.     

Poverty and educational achievement in the US: A less-biased estimate using PISA 2012 data

In the current paper, we employ the most recent Programme for International Student Assessment (PISA) data to calculate a less-biased estimate of poverty on US achievement. The PISA was specifically chosen as it is an assessment removed from a specific curriculum and instead focuses on concepts that students should know in order to participate in a global economy. Using a propensity score matching approach, our findings suggest that US students in poverty have notable educational attainment deficiencies compared to a matched group of students who are not in poverty. In other words, when we select two students who have a great deal in common but for the fact that one comes from a poverty background, the student in poverty is expected to perform nearly 28 points, or about a quarter of a standard deviation lower, on the PISA assessment. In real terms, this puts math achievement for children not in poverty on-par with the Organisation for Economic Co-operation and Development (OECD) average, while children in poverty are well below the OECD average.     

The case of vegetovascular dystonia: inventing the most common Soviet disease

ABSTRACT

The paper considers the case of vegetovascular dystonia, one of the most typical and common “Soviet” diseases. This syndrome emerged in Soviet medicine after World War II, and very quickly become a popular diagnosis among physicians. The author describes how the construct of vegetovascular dystonia was formed and developed, what changes it underwent, and what affected those changes. The concept and history of vegetovascular dystonia can provide an understanding of Soviet medicine and health science in general.     

参加医疗保险对农村居民健康的影响——基于CHARLS 2015数据的实证分析

基于CHARLS 2015数据,采用倾向得分匹配法实证分析参加医疗保险对农村居民健康的影响。研究发现:参加医疗保险对农村居民的日常活动能力和自评健康影响不显著,参加医疗保险对农村居民认知能力具有显著的正向影响。据此提出,应进一步提升社会医疗保险保障水平、扩大社会医疗保险保障范围、促进商业医疗保险有序发展、推进"三医"高效协同联动等,以充分发挥医疗保险的健康保障功能,从而进一步提升参加医疗保险对农村居民健康的正向影响。     

The importance of cross‐disciplinary scientific engagement in the development of quantitative procedures for aggregate safety assessments

Recent guidance on safety monitoring during drug development, issued by regulatory authorities in the United States and European Union, indicate a shift in focus towards aggregate safety monitoring and scientific evaluation of integrated safety data. The call for program‐level reviews of accumulating safety data, including from ongoing studies, provides an opportunity to leverage the scientific expertise and medical judgment of safety management teams with (a) a multidisciplinary approach, (b) quantitative frameworks to measure level of evidence, and (c) assessments that are product‐specific and driven by medical judgment. A multidisciplinary team, regularly reviewing aggregate safety data throughout the development program, is vital not only for early signal detection but also for generating a better understanding of the accumulating data and context needed for decreasing false alarms.     

Constructing ‘disability’ in Myanmar: teachers,community stakeholders,and the complexity of disability models

This article explores Myanmar teachers’ and community stakeholders’ constructions of disability. We examine how various religious perspectives – particularly Buddhism – inform and shape understandings of impairment and how these beliefs intersect with a strongly medicalised construction of disability. However, in our discussion and exploration of the responses, we also found that the notion of two primary disability ‘models’ – namely the medical model and the social model – lack nuance, complexity, and socio-cultural consideration. Through examining teachers’ and community members’ perspectives of disability in Myanmar, we highlight the importance of socio-cultural variance in understanding local constructions of disability.     

医生的信息-情感交互模式对移动问诊服务满意度的影响——基于“激励-保健”理论的分析

移动问诊服务日益成熟，但患者满意度仍有待提高。现有研究对医患交互过程关注不足，且忽略患者不满意评价的影响因素。为此，本文引入"激励-保健"理论视角，研究医生的信息-情感交互模式对移动问诊服务满意及不满的影响机制。本文筛选国内某领先移动问诊平台中的300次医患沟通记录，采用"先定性后定量"的混合研究方法对数据进行分析。其中，定性研究旨在识别医生交互模式的细分维度，定量研究则用于提出并验证不同交互模式与患者满意及不满的关系。研究发现，医生的信息交互模式是移动问诊服务满意度的保健因素，而情感交互模式是激励因素。结论丰富了移动问诊服务患者满意度的研究框架，对改善医生行为和医疗服务APP设计提供了指导。     

邓小平四川藏区民主改革思想与实践

民主改革是20世纪中后期中国共产党采取协商方式，领导部分边疆民族地区上层人士及劳动人民，开展以废除奴隶制或农奴制、消除剥削压迫、土地改革为中心的社会改造。建国初期，邓小平等依据民主主义的任务，结合民族地区实际，提出采取协商方式、实行宽大措施开展土改的构想。再经总结，提升为民主改革（和平协商土地改革、直接过渡），载之宪法，成为共产党的“既定方针”，改造部分民族旧社会形态。即使采取协商方式开展改革，也有可能遭到反对。针对叛乱，邓小平确定“政治争取为主与军事打击结合”的方针，组织群众，平息叛乱，保障改革、坚决改革。在改革上，邓小平及时作出指示，引导改革顺利开展，确定“发动群众、上层协商”的改革方针。“发动群众”表明改革依靠群众；“上层协商”反映用“赎买”施以改革，从而形成有中国特色的社会改造方式。文章通过对为什么要改革、怎样改革、依靠谁改革，以及如何对待叛乱的分析，阐述了邓小平对民主改革的认识，也是邓小平解决部分民族地区社会形态的理论成果。     

Using the Delphi Method to Classify Medical Specialties

One medical specialty classification system applicable for research and career counseling is the person‐oriented versus technique‐oriented taxonomy. Given that the model was conceptualized in the 1960s, verification based on how medical specialties are practiced and viewed today is necessary. Five specialists in medical career development and advising verified the categorization of specialties. Based on their review, 100% consensus was reached regarding grouping of specialties. This outcome validates the taxonomy of medical specialties and supports its continued use for medical career specialty advising and choice.     

Designing Graphs that Promote Both Risk Understanding and Behavior Change

Graphs show promise for improving communications about different types of risks, including health risks, financial risks, and climate risks. However, graph designs that are effective at meeting one important risk communication goal (promoting risk‐avoidant behaviors) can at the same time compromise another key goal (improving risk understanding). We developed and tested simple bar graphs aimed at accomplishing these two goals simultaneously. We manipulated two design features in graphs, namely, whether graphs depicted the number of people affected by a risk and those at risk of harm (“foreground+background”) versus only those affected (“foreground‐only”), and the presence versus absence of simple numerical labels above bars. Foreground‐only displays were associated with larger risk perceptions and risk‐avoidant behavior (i.e., willingness to take a drug for heart attack prevention) than foreground+background displays, regardless of the presence of labels. Foreground‐only graphs also hindered risk understanding when labels were not present. However, the presence of labels significantly improved understanding, eliminating the detrimental effect of foreground‐only displays. Labels also led to more positive user evaluations of the graphs, but did not affect risk‐avoidant behavior. Using process modeling we identified mediators (risk perceptions, understanding, user evaluations) that explained the effect of display type on risk‐avoidant behavior. Our findings contribute new evidence to the graph design literature: unlike what was previously feared, we demonstrate that it is possible to design foreground‐only graphs that promote intentions for behavior change without a detrimental effect on risk understanding. Implications for the design of graphical risk communications and decision support are discussed.