The logic of strategic ignorance

Ignorance and knowledge are often thought of as opposite phenomena. Knowledge is seen as a source of power, and ignorance as a barrier to consolidating authority in political and corporate arenas. This article disputes this, exploring the ways that ignorance serves as a productive asset, helping individuals and institutions to command resources, deny liability in the aftermath of crises, and to assert expertise in the face of unpredictable outcomes. Through a focus on the Food and Drug Administration's licensing of Ketek, an antibiotic drug manufactured by Sanofi-Aventis and linked to liver failure, I suggest that in drug regulation, different actors, from physicians to regulators to manufacturers, often battle over who can attest to the least knowledge of the efficacy and safety of different drugs - a finding that raises new insights about the value of ignorance as an organizational resource.     

Confrontations and donations: encounters between homeless pet owners and the public

This study examines the interactions between homeless pet owners and the domiciled public with a focus on how the activities of pet ownership help construct positive personal identities. Homeless people are often criticized for having pets. They counter these attacks using open and contained responses to stigmatization. More often, they redefine pet ownership to incorporate how they provide for their animals, challenging definitions that require a physical home. Homeless pet owners thus create a positive moral identity by emphasizing that they feed their animals first and give them freedom that the pets of the domiciled lack. Through what we call “enabled resistance,” donations of pet food from the supportive public provide the resources to minimize the impact of stigmatization.     

Why medicalization? Introduction to the special issue on the medicalization of sex

This special issue grows out of the need to bring into focus the historical and sociocultural contextualization of sex to the sexological community. The specific focus is on analyzing how medicalization is affecting many areas of sexual life and discourse, but the larger goal is to help situate sexuality studies in its broadest perspective. Articles will be of general interest to those interested in interdisciplinary scholarship; the specific articles address HIV politics, sex therapy, women's sexual health, sex and aging, the popularization of weak science, and the media's view that sexual exuberance is a central marker of recovery from cancer. Medicalization is a current trend that illuminates the importance of a broader view of sexology.     

Making it real: using standardized patients to bring case studies to life

With increases in the overall number of individuals with posttraumatic stress disorder (PTSD), nurse educators must provide experiences that help nursing students learn how to better communicate and care for individuals with this disorder. This article describes how two learning strategies-case studies and standardized patients-were combined to facilitate the development of therapeutic communication and assessment skills. Two case studies on PTSD were written, and actors were trained to portray the individuals in the case studies. Fourteen baccalaureate nursing students enrolled in a senior-level psychiatric nursing clinical course participated in this pilot alternative learning activity. This article describes the learning activity and presents student evaluations of the assignment.     

The incidence of metabolic risk factors in an inpatient psychiatric setting

Our study examines risk factors for metabolic syndrome on admission to an acute psychiatric facility and the incidence of medical referrals at discharge. Data on demographics, risk factors for metabolic syndrome, other health risk factors, medications, related diagnoses, and primary care providers and referrals were collected from 125 psychiatric patient charts. Comparison analysis was done for two groups: those with two or more risk factors for metabolic syndrome and those with less than two risk factors. Differences between groups were statistically significant for age, waist circumference, body mass index, high-density lipoprotein, triglycerides, and fasting glucose levels. Few patients were referred to their primary care provider for follow-up care. This study has clinical implications for improving assessment of psychiatric patients at risk for developing metabolic syndrome, for designing interventions to help patients adopt lifestyle changes to mitigate these risks, and for working toward fuller integration of psychiatric and primary care.     

Dating violence: mental health consequences based on type of abuse

This study aims to determine the relationship between psychological, physical, and sexual abuse, and mental health symptoms. Female college students (N = 499) completed anonymous online surveys to report experiences of abuse, as well as symptoms of depression, posttraumatic stress disorder (PTSD), and physical injuries. Five groups of participants were found: no abuse; psychological abuse; physical abuse; psychological and physical abuse; and psychological, physical, and sexual abuse. The multiple abuse groups showed the highest rate of mental health symptoms. In addition, increased frequency of abuse was related to more mental health symptoms and more physical injuries.     

Resolving mobility constraints impeding rural seniors' access to regionalized services

Rural and small town places in developed economies are aging. While attention has been paid to the local transportation needs of rural seniors, fewer researchers have explored their regional transportation needs. This is important given policies that have reduced and regionalized many services and supports. This article explores mobility constraints impeding rural seniors' access to regionalized services using the example of northern British Columbia. Drawing upon several qualitative studies, we explore geographical, maintenance, organizational, communication, human resources, infrastructure, and financial constraints that affect seniors' regional mobility. Our findings indicate that greater coordination across multiple government agencies and jurisdictions is needed and more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy. In addition to discussing the complexities of these geographies, the article identifies innovative solutions that have been deployed in northern British Columbia to support an aging population. This research provides a foundation for developing a comprehensive understanding of the key issues that need to be addressed to inform strategic investments in infrastructure and programs that support the regional mobility and, hence, healthy aging of rural seniors.     

Ergonomic initiatives at Inmetro: measuring occupational health and safety

This work studies biomechanical hazards to which the workforce of Instituto Nacional de Metrologia, Qualidade e Tecnologia Industrial (Inmetro) is exposed. It suggests a model for ergonomic evaluation of work, based on the concepts of resilience engineering which take into consideration the institute's ability to manage risk and deal with its consequences. Methodology includes the stages of identification, inventory, analysis, and risk management. Diagnosis of the workplace uses as parameters the minimal criteria stated in Brazilian legislation. The approach has several prospectives and encompasses the points of view of public management, safety engineering, physical therapy and ergonomics-oriented design. The suggested solution integrates all aspects of the problem: biological, psychological, sociological and organizational. Results obtained from a pilot Project allow to build a significant sample of Inmetro's workforce, identifying problems and validating the methodology employed as a tool to be applied to the whole institution. Finally, this work intends to draw risk maps and support goals and methods based on resiliency engineering to assess environmental and ergonomic risk management.