Re-inscribing Gender in New Modes of Medical Expertise: The Investigator-Coordinator Relationship in the Clinical Trials Industry

This article analyses the ways in which research coordinators forge professional identities in the highly gendered organizational context of the clinic. Drawing upon qualitative research on the organization of the clinical trials industry (that is, the private sector, for profit auxiliary companies that support pharmaceutical drug studies), this article explores the relationships between predominantly male physician-investigators and female research coordinators and the constitution of medical expertise in pharmaceutical drug development. One finding is that coordinators actively seek to establish relationships with investigators that mirror traditional doctor-nurse relationships, in which the feminized role is subordinated and devalued. Another finding is that the coordinators do, in fact, have profound research expertise that is frequently greater than that of the investigators. The coordinators develop expertise on pharmaceutical products and diseases through their observations of the patterns that occur in patient-participants' responses to investigational drugs. The article argues, however, that the nature of the relationships between coordinators and investigators renders invisible the coordinators' expertise. In this context, gender acts as a persistent social structure shaping both coordinators' and investigators' perceptions of who can be recognized as having authority and power in the workplace.     

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Abstract

Cardiac patients frequently experience anxiety and depression as major responses to a life-threatening event. Well-timed intervention by the social worker can assist in alleviating these responses and enhance psychological well-being by the use of counselling and other therapeutic techniques. Two case-studies are presented illustrating the range of work undertaken in a comprehensive approach to working with patients in both the acute and rehabilitation phases of cardiac crisis.     

Sex differences in the vocabulary of college students

The present study replicated Jastrow's 1891 experiment concerning differences between male and female vocabulary. Participants were 20 male and 20 female Caucasian middle‐class college students. They recorded up to 100 nouns in a 15‐minute period. Results indicate that women have increased their use of unusual words compared to women in 1891. Males used more scientific words and more body part words than females. In contrast to the previous study, there are no significant differences between the sexes in use of animal, nature, and food words. Females used more clothing words than males in this study, as in the previous study, and produced more different words than males. Vocabulary changes appear to reflect changes in the social structure of the society.     

Researching Disability Politics, Or, Some Problems with the Social Model in Practice

This article arises from a research project involving the disabled members' group in UNISON, and problematises the social model which explicitly undergirds the discourses and practices of this group. In abstract terms, there are dangers that the social model can be interpreted in a way which privileges some impaired identities over others, sanctions a separatist ghetto which cannot reach out to other groups of disabled and disadvantaged people, and weaves a tangled web around researchers who adhere to the emancipatory paradigm. In concrete terms, these dangers are explored with reference to the stories of impaired people who believe that they are excluded from the disabled members' group, the predicaments of ex-disabled and differently-disabled people in relation to the movement, and the culture of suspicion surrounding academics, particularly the 'non-disabled' researcher as would-be ally. It is argued that, whilst such identities and issues might appear to be 'marginal' ones in the sense of occurring at the boundary of disabled communities, disability politics and disability studies, they should not be 'marginalised' by disabled activists and academics, and indeed that they pose challenges to our collective identities, social movements, theoretical models and research paradigms which need to be addressed.     

Employee stress litigation: The UK experience

This paper considers the extent to which stress-induced illness can be regarded as a personal injury that could give rise to civil action for damages against employers in the UK. It outlines the results of a brief survey of personal injury solicitors, which indicates that claims are already being initiated by employees who allege they have suffered a stress-induced illness. The potential for claims within industrial tribunal cases that have already been decided is also examined. Consideration is given to the hurdles that litigants will have to surmount, such as proving that their condition was in fact caused by some feature of their working conditions, showing that it was foreseeable that they would suffer a stress-based injury, and demonstrating that their employer was in some way at fault. This leads to a questioning of what employers can do to protect themselves from such claims, or at least defend them successfully. The paper points out that success is likely to depend heavily upon the quality of expert medical opinion, and also upon policy conditions that may influence those adjudicating on such cases. It is concluded that the cost of losing claims may be significant, and that employees who ignore the warning signs do so at their peril.     

A Further Examination of Cumulative Prospect Theory Parameterizations

Recent experimental studies have focused on fitting parameterized functional forms to cumulative prospect theory's weighting function. This paper examines the behavioral implications of the functional forms and the estimated parameters. We find that none of the parameterizations can simultaneously account for gambling on unlikely gains and the Allais paradox behavior or other strong choice patterns from experiments. Parameter estimates that lead to reasonable amounts of insurance and gambling behavior tend to also generate large risk premia. Taken as a whole, the analysis suggests that the functional forms proposed in the literature are not suitable for generalization to applied settings.     

Reproducibility of clinical data I: continuous outcomes

Across a variety of clinical settings, repeated measurements on an individual, obtained under identical circumstances, often differ from one another. This implies the measurements lack perfect reproducibility. Topics related to reproducibility of clinical measurements are introduced in this paper. In this first of two parts, continuous outcomes are addressed. The intraclass correlation coefficient, ρ, has been the traditional coefficient of reproducibility for continuous outcomes. The importance of ρ regarding observations on an individual, and observations among populations, is outlined. Estimation and inferential procedures for ρ are reviewed and worked examples are provided. Copyright © 2004 John Wiley & Sons, Ltd.     

WOMEN'S ACCESS TO PENSIONS AND THE STRUCTURE OF ELIGIBILITY RULES:

Because many older women lack access to private pensions and rely solely on social security income, they are significantly more likely than men to have incomes below or near poverty level. Liberal feminists attribute women's failure to attain pensions to their discontinuous work histories, which preclude them from meeting requirements for length and continuity of service. Such a conclusion ignores the invisible gender-based distinctions arising from the organizational logic of the workplace. The key issue is not why women fail to satisfy pension rules but rather why the rules are structured to penalize women for their reproductive labor. This historical case study of the pension negotiation process in two unions, the United Auto Workers and the International Ladies Garment Workers Union, indicates that the price women pay in the market for their domestic labor is a social construction that arises from specific decisions in the workplace. The analysis suggests that women can improve their status relative to men if they are able to reveal the hidden dimensions of gender in societal institutions but that they cannot attain full equality until the distinction between social production and reproduction is eliminated.