Computer decision support tools in primary care

Computer Decision Support Tools (CDSTs) can support clinicians at various stages of the care process and improve healthcare, but implementation of these tools has been difficult. In this study we examine the need for, the use of, and barriers and facilitators to the use of a CDST from a human factor perspective. Results show that there is a need for CDSTs, and that physicians do use well-developed CDSTs. However, there are also barriers against the use, such usability issues and problems fitting them into the clinical workflow.     

Racializing Redemption,Reproducing Racism: The Odyssey of Magical Negroes and White Saviors

Recent research on the intersection of race and media describes a trend of progressive, even antiracist, narratives that showcase close inter‐racial friendships and camaraderie on the silver screen. Films in which one character saves or helps another from some unholy or disastrous plight are common in films like The Green Mile (1999), Bruce Almighty (2003), Amistad (1997) and The Blind Side (2009). While these films present a stark change from the patently racist and on‐screen segregationist history of Hollywood cinema, these films often trade on racist meanings and expectations. Many of these films are what critics call “Magical Negro” or “White Savior” films – cinema in which implicit and explicit racial stereotypes are employed to structure the inter‐racial interactions where one character labors to redeem another. In comparing these two genres, this article provides an overview for how both cinematic forms reproduce racist messages by naturalizing the supposed cerebral rationality, work ethic, and paternalistic morality of select White characters while normalizing Black characters as primordially connected with nature, spiritually connected to the carnal, and possessive of exotic and magical powers. Together, these films subversively reaffirm the social order and relations of racial domination by reproducing centuries’ old understandings of racial difference.     

Pathways to early coital debut for adolescent girls: a recursive partitioning analysis

This study examined pathways to early coital debut among early to middle adolescent girls in the United States. In a two-year longitudinal study of 104 adolescent girls, recursive partitioning (RP) analyses were conducted to examine the specific factors that were related to engaging in first intercourse by the 10th grade among adolescent girls who had not yet engaged in sexual intercourse by the 8th grade. RP analyses identified subsamples of girls who had low, medium, and high likelihoods of engaging in early coital debut based on six variables (i.e., school aspirations, early physical intimacy experiences, depression, body objectification, body image, and relationship inauthenticity). For example, girls in the lowest likelihood group (3% had engaged in sex by the 10th grade) reported no prior experiences with being touched under their clothes, low body objectification, high aspirations to complete graduate education, and low depressive symptoms; girls in the highest likelihood group (75% had engaged in sex by the 10th grade) also reported no prior experiences with being touched under their clothes, but had high levels of body objectification. The implications of these analyses for the development of female adolescent sexuality, as well as for advances in quantitative methods, are discussed.     

Gendered uncertainty and variation in physicians' decisions for coronary heart disease: the double-edged sword of "atypical symptoms"

Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians' interpretations of patient sex-gender affect diagnostic certainty and, in turn, decision making for coronary heart disease. Data are from a factorial experiment of 256 physicians who viewed 1 of 16 video vignettes with different patient-actors presenting the same symptoms of coronary heart disease. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have "atypical symptoms" as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge.     

Socio-economic wellbeing in Australian mining towns: A comparative analysis

Understanding the links between resource dependence and socio-economic wellbeing has long been a subject of interest amongst social scientists in North America. By contrast, relatively few Australian studies exist on this topic. This is despite the significant role of resource industries in shaping Australia's economic and social geography. Where research has been undertaken it tends to focus on the experience of a single town or region. This paper presents a cross-sectional analysis of socio-economic performance across 33 small mining towns in Western Australia. We design and test a number of empirical models that are hypothesised to account for the variability in socio-economic performance across different resource industry contexts. The results of the analysis suggest that socio-economic wellbeing in these towns is highly variable, and contingent on a range of factors including the nature of the particular commodity, company structure, and location.     

A Longitudinal Study of the Developmental Trajectories of Parental Attachment and Career Maturity of South Korean Adolescents

This study tested the developmental trajectories of career maturity (CM) and parental attachment (PA), the longitudinal influence of both, and gender as a moderator. Findings showed developmental progressions in adolescents’ PA and CM over 4 years. The change in PA was positively related to the developmental change in CM. For gender, there was a statistically significant difference in the initial status of CM and PA but no significant difference in developmental change. This study verified the longitudinal influence of PA on CM and showed that the cross‐sectional effect of predictors on CM needs to be distinguished from the longitudinal effect in future studies.     

Involving People with Profound and Multiple Learning Disabilities in Social Work Education: Building Inclusive Practice

Abstract

Service user and carer engagement is a foundational requirement of social work education. Despite this, questions remain about how diverse experiences are represented and who might be excluded from involvement. This paper focusses on one group of people who it is suggested are excluded from involvement, people with profound and multiple learning disabilities. Evidence is presented which demonstrates the extent to which this group have been marginalised and excluded from processes of involvement. The paper then provides a case study of one universities’ experience of developing work in this area, when a man with profound and multiple learning disabilities was commissioned to design and deliver specialist teaching for a group of qualifying social work students. We argue that the main barrier to inclusive involvement for people with profound and multiple learning disabilities is the attitudes and assumption of others about what they are capable of. We demonstrate how involvement in social work education helps to address these barriers by challenging the assumptions of students, the academy and society more broadly.     

There's Something Happening Here: A Comment on Hirschfield's “Lethal Policing”

This essay serves as a response to Hirschfield's (2015) article, “Lethal Policing: Making Sense of American Exceptionalism,” published in the December 2015 issue of this journal.     

Identity Isomorphism: Role Schemas and White Masculinity Formation

This article explores a counterintuitive intersection of class, gender, and race within two politically antagonistic white movements—white nationalists and white antiracists. Ethnographic field‐notes, in‐depth interviews, and content analysis provide comprehensive data and triangulation for how implicit perceptions of class and gender are intertwined with the social construction of an ideal white, male, middle‐class identity. While both organizations express antithetical political goals, they together reinforce broader discourses about whiteness and white supremacy. In so doing, these two organizations present an empirical and theoretical puzzle: How and why do two supposedly antithetical and divergent white male organizations simultaneously rationalize the inclusion and exclusion of women and the lower class from their ranks? Findings gesture toward tempering conceptual models of white male identity formation to further explore how cultural schemas are utilized toward the construction of both identity formation and interest protection.