Alarmed: sensory approaches to improving medical alarm systems

Medical alarms sound incessantly, loudly, and dissonantly, contributing to an already noisy ICU and OR soundscape, and ultimately harming both patients and staff. Sometimes triggered in error, the sheer number of alarms distracts health care professionals and results in sensory overload that contributes to hospital staff’s alarm fatigue. In turn, staff become increasingly likely to ignore alarms instead of acting on them. Furthermore, the patients’ sensitivity to alarms disturbs their hospital stay, raises their stress levels, and impedes their recovery process, with sometimes lasting effects. This article considers the sensory effects of hospital alarms and possibilities for redesigning future alarm systems, with the goal of eventually creating a more calming, less stressful, and safer hospital soundscape environment for all.     

School beyond stratification: Internal goods,alienation, and an expanded sociology of education

Theory and Society - Sociologists of education often emphasize goods that result from a practice (external goods) rather than goods intrinsic to a practice (internal goods). The authors draw from...     

The Politics of Expanding Healthcare Access to the Poor and Informal Sectors

How do the politics of agenda setting and policy adoption operate in the arena of healthcare reform in the industrializing world? Literature on the twenty‐first‐century developmental state emphasizes the role of democratic competition and civil society in causing political parties to take up new agendas, while power resources theory stresses the role of left‐wing political parties and labor unions in policy adoption. Yet, core tenets of these theories have not been considered extensively in light of dynamics in the industrializing world. This article examines the politics of policy adoption in countries that have recently aimed to provide healthcare access and financial protection to the poor and people in the informal sector in Mexico and Turkey. In line with literature on the twenty‐first‐century developmental state, we find democratic competition to play an important role in causing political parties to take up new agendas. However, examination of the cases illuminates surprising dynamics that challenge important elements of sociological theory: right‐leaning political parties played important roles in adoption, while labor unions and left‐wing parties oppose reform in the cases. Public health‐minded physicians leading change teams played important roles in agenda setting and leading the process of implementation.     

Do Interactions Between Environmental Chemicals and the Human Microbiome Need to Be Considered in Risk Assessments?

One of the most dynamic and fruitful areas of current health‐related research concerns the various roles of the human microbiome in disease. Evidence is accumulating that interactions between substances in the environment and the microbiome can affect risks of disease, in both beneficial and adverse ways. Although most of the research has concerned the roles of diet and certain pharmaceutical agents, there is increasing interest in the possible roles of environmental chemicals. Chemical risk assessment has, to date, not included consideration of the influence of the microbiome. We suggest that failure to consider the possible roles of the microbiome could lead to significant error in risk assessment results. Our purpose in this commentary is to summarize some of the evidence supporting our hypothesis and to urge the risk assessment community to begin considering and influencing how results from microbiome‐related research could be incorporated into chemical risk assessments. An additional emphasis in our commentary concerns the distinct possibility that research on chemical–microbiome interactions will also reduce some of the significant uncertainties that accompany current risk assessments. Of particular interest is evidence suggesting that the microbiome has an influence on variability in disease risk across populations and (of particular interest to chemical risk) in animal and human responses to chemical exposure. The possible explanatory power of the microbiome regarding sources of variability could reduce what might be the most significant source of uncertainty in chemical risk assessment.     

Breadth of Vocational Interests: The Role of Career Adaptability and Future Orientation

The authors examined the relationship between career adaptability, future orientation, and vocational interests. Specifically, they tested the role of career adaptability and future orientation in promoting a broader range of vocational interests, based on the principle that experiencing more interests can be useful in giving one's best in multiple occupations and in planning a broad range of career goals. A total of 762 Italian adolescents (383 males, 379 females) participated in the study. Results highlight the mediating role of future orientation in the relationship between 4 career adaptability resources and breadth of vocational interests. These results underscore that specific interventions in career adaptability and future orientation may foster a broader range of vocational interests, providing more opportunity for adolescents to respond to the demands of the current job market.     

Linking Decision Theory and Quantitative Microbial Risk Assessment: Tradeoffs Between Compliance and Efficacy for Waterborne Disease Interventions

Achieving health gains from the U.N. Sustainable Development Goals of universal coverage for water and sanitation will require interventions that can be widely adopted and maintained. Effectiveness—how an intervention performs based on actual use—as opposed to efficacy will therefore be central to evaluations of new and existing interventions. Incomplete compliance—when people do not always use the intervention and are therefore exposed to contamination—is thought to be responsible for the lower‐than‐expected risk reductions observed from water, sanitation, and hygiene interventions based on their efficacy at removing pathogens. We explicitly incorporated decision theory into a quantitative microbial risk assessment model. Specifically, we assume that the usability of household water treatment (HWT) devices (filters and chlorine) decreases as they become more efficacious due to issues such as taste or flow rates. Simulations were run to examine the tradeoff between device efficacy and usability. For most situations, HWT interventions that trade lower efficacy (i.e., remove less pathogens) for higher compliance (i.e., better usability) contribute substantial reductions in diarrheal disease risk compared to devices meeting current World Health Organization efficacy guidelines. Recommendations that take into account both the behavioral and microbiological properties of treatment devices are likely to be more effective at reducing the burden of diarrheal disease than current standards that only consider efficacy.     

Profiles of Housing Cost Burden in the United States

In this study, the ordered logistic regression model indicates that renters suffer a greater housing cost burden than homeowners and that the lower the income of the household, the larger the portion of income that is spent for housing. Further, the model also shows that the burden of high housing costs falls disproportionately on certain groups of American households. Compared to the reference group, two single-risk groups (Asian-American households and households with three or more children) and two dual-risk groups (female-headed households with three or more children and minority households with three or more children) tend to have a higher risk of excessive housing costs. Elderly households and three elderly-related groups (female-headed elderly households, minority elderly households, and female-headed minority elderly households), however, tend to have a lower risk of housing cost burden than other households. The housing cost burden of the reference group is comparable to the housing cost burden of each of the following groups: for single female-headed households; Black households; Hispanic households; and female-headed minority households. The policy implications of these findings are discussed in the paper.     

Principles for Conduct of Pest Risk Analyses: Report of an Expert Workshop

The North American Free Trade Agreement (NAFTA) and the General Agreement on Tariffs and Trade (GATT) have focused attention on risk assessment of potential insect, weed, and animal pests and diseases of livestock. These risks have traditionally been addressed through quarantine protocols ranging from limits on the geographical areas from which a product may originate, postharvest disinfestation procedures like fumigation, and inspections at points of export and import, to outright bans. To ensure that plant and animal protection measures are not used as nontariff trade barriers, GATT and NAFTA require pest risk analysis (PRA) to support quarantine decisions. The increased emphasis on PRA has spurred multiple efforts at the national and international level to design frameworks for the conduct of these analyses. As approaches to pest risk analysis proliferate, and the importance of the analyses grows, concerns have arisen about the scientific and technical conduct of pest risk analysis. In January of 1997, the Harvard Center for Risk Analysis (HCRA) held an invitation-only workshop in Washington, D.C. to bring experts in risk analysis and pest characterization together to develop general principles for pest risk analysis. Workshop participants examined current frameworks for PRA, discussed strengths and weaknesses of the approaches, and formulated principles, based on years of experience with risk analysis in other setting and knowledge of the issues specific to analysis of pests. The principles developed highlight the both the similarities of pest risk analysis to other forms of risk analysis, and its unique attributes.     

The American sociologist: Characteristics in the 1990s

This article describes the characteristics, theoretical preferences, and political orientations of sociologists in the United States. The findings are the most representative of their kind reported to date. Other professional groups, such as psychiatrists, have been studied over time (Gallagher, 1977; Gallagher et al., 1987; Gallagher et al., 1990), but studies of sociologists have been almost non-existent. In fact, there has only been one study of this nature conducted in the 1990s, and that one sampled only sociologists whose names appeared on the membership list of the American Sociological Association (Sanderson and Ellis, 1992). However, that sampling frame did not provide a representative cross-section of American sociologists because it excluded the large proportion of sociologists who are not members of the ASA and who probably are systematically different than members. It is ironic that sociologists who intensively study the characteristics of all sorts of groups know so little about themselves. That is a major reason why this project was undertaken.     

灾害中残疾人的媒介使用与信息沟通需求——以汶川地震为例

在灾害情况下,残疾人群所面临的沟通困境要远远高于正常人群,甚至连最基本的信息需求都无法得到保障。从2008年汶川地震中残疾人群媒介使用的特征和信息沟通需求来看,对这部分弱势群体的保护需要在法律和政策上给予更多的支持:改善信息发布和传递的渠道,使用新的技术手段,培养残疾人使用媒介的良好习惯。