Vaccines and the social amplification of risk.

In 2019, the World Health Organization (WHO) named "Vaccine Hesitancy" one of the top 10 threats to global health. Shortly afterward, the COVID-19 pandemic emerged as the world's predominant health concern. COVID-19 vaccines of several types have been developed, tested, and partially deployed with remarkable speed; vaccines are now the primary control measure and hope for a return to normalcy.

Social Perception of Systemic Risks.

The article distinguishes between two types of risks: conventional and systemic risks. Conventional risks can be contained in space and time, follow linear cause-effect relationships and can be addressed with effective and pointed interventions into the cause-effect chain. Systemic risks, however, are characterized by high complexity, transboundary effects, stochastic relationships, nonlinear cause-effect patterns with tipping points, and are often associated with less public attention than they require.

Through a Glass Darkly: How Natural Science and Technical Communities Looked at Social Science Advances in Understanding Risk.

This article is one piece in a series of articles that reflect on advances in ideas about risk made by social science over the past 40 years and more. It differs from the other articles: its focus is not on specific advances themselves, but rather on how those advances were received and were encouraged or discouraged by the natural science and technical members of the risk community. Thus, the principal goal of this article is to provide some context for the other articlers in this series.

Two Types of Vigilance Are Essential to Effective Hazard Management: Maintaining Both Together Is Difficult.

Flexibility and adaptability are key capabilities for coping with persistent and pervasive uncertainties. The systematic organization of these capabilities is often called "adaptive management"; it is key to effective hazard management and important in risk governance. Vigilance is a requirement for effective adaptation.

Third Party Interaction in the Medical Context: Code-switching and Control.

The purpose of this paper is to examine the micro-interactional co-construction of power within Spanish language concordant medical consultations in California involving a third party family member. Findings indicate the third party instigates code-switching to English on the part of medical providers, a language that the patient does not understand, rendering the patient a non-participant in the medical consultation. In these consultations involving a third party family member, monolingual Spanish-speaking patients are stripped of control in ways that are similar to other powerless groups in medical consultations.

‘Shift’ ‘n ‘control’: The computer as a third interactant in Spanish-language medical consultations.

The purpose of this paper is to examine the role of the computer in medical consultations in which English- Spanish-bilingual medical providers interact with Spanish-monolingual patients. Following previous studies that have revealed that the presence of the computer in consultations detracts from direct provider– patient communication, we pay specific attention to how the use of the computer in Spanish-language medical consultations can complement or adversely affect the co-construction of the patient’s health narrative. The data for the present study consist of 36 Spanish-language medical consultations in Southern California.

Early experience with ultrasound features after intrabeam intraoperative radiation for early stage breast cancer.

Background: Intraoperative radiation therapy (IORT) is an emerging option for partial breast radiotherapy in select women with early stage breast cancer. We assessed short-term clinical and sonographic findings after breast conservation (BCT) and IORT.

Methods: An IRB-approved, single institution retrospective chart review was conducted of patients (pts) treated with BCT/IORT from 1/2011 to 6/2012.

Constructing language normativity through the animation of stance in Spanish-language medical consultations.

The purpose of this study is to examine the construction of language normativity as medical providers interact with patients and animate stance within Spanish-language medical consultations. The context of the study is a clinic in which providers use Spanish to communicate with monolingual Spanish-speaking patients. This clinic is in the United States, an English-speaking macro-societal context.

Risk assessment can be a game-changing information technology--but too often it isn't.

The printing press was a game-changing information technology. Risk assessment could be also. At present, risk assessments are commonly used as one-time decision aids: they provide justification for a particular decision, and afterwards usually sit on a shelf.

Narrative co-construction in the medical consultation: how agency and control affect the diagnosis.

The purpose of this paper is to examine patient-provider narrative co-construction of symptoms, diagnosis and treatment in the medical consultation. Narrative scholarship has demonstrated that conversational narratives, including those that take place in medical consultations, are typically co-constructed by all participants within the conversation. In the context of the medical consultation, this means that patient narratives are co-constructed with providers, and that at times, provider contributions to the patient narrative can hide patient contributions.

Well, Now, Okey Dokey: English Discourse Markers in Spanish Language Medical Consultations.

The purpose of this paper is to examine use of English discourse markers in otherwise Spanish language consultations. Data is derived from an audio-recorded corpus of Spanish language consultations that took place in a small community clinic in the United States as well as post-consultation interviews with patients and providers. Through quantification of the use of discourse makers in the corpus and discourse analysis of transcripts, we demonstrate that English-speaking dominant medical providers use English discourse markers more frequently and with a broader range of functions than do Spanish-speaking dominant medical providers and patients.

Vulnerability, risk perception, and health profile of marginalized people exposed to multiple built-environment stressors in Worcester, Massachusetts: a pilot project.

Millions of low-income people of diverse ethnicities inhabit stressful old urban industrial neighborhoods. Yet we know little about the health impacts of built-environment stressors and risk perceptions in such settings; we lack even basic health profiles. Difficult access is one reason (it took us 30 months to survey 80 households); the lack of multifaceted survey tools is another.

Participatory testing and reporting in an environmental-justice community of Worcester, Massachusetts: a pilot project.

Background: Despite indoor home environments being where people spend most time, involving residents in testing those environments has been very limited, especially in marginalized communities. We piloted participatory testing and reporting that combined relatively simple tests with actionable reporting to empower residents in Main South/Piedmont neighborhoods of Worcester, Massachusetts. We answered: 1) How do we design and implement the approach for neighborhood and household environments using participatory methods? 2) What do pilot tests reveal? 3) How does our experience inform testing practice?

Methods: The approach was designed and implemented with community partners using community-based participatory research.

Vulnerability-based spatial sampling stratification for the National Children's Study, Worcester County, Massachusetts: capturing health-relevant environmental and sociodemographic variability.

Background: The National Children's Study is the most ambitious study ever attempted in the United States to assess how environmental factors impact child health and development. It aims to follow 100,000 children from gestation until 21 years of age. Success requires breaking new interdisciplinary ground, starting with how to select the sample of > 1,000 children in each of 105 study sites; no standardized protocol exists for stratification of the target population by factoring in the diverse environments it inhabits.

Human vagal baroreflex mechanisms in space.

Although astronauts' cardiovascular function is normal while they are in space, many have altered haemodynamic responses to standing after they return to Earth, including inordinate tachycardia, orthostatic hypotension, and uncommonly, syncope. Simulated microgravity impairs vagal baroreceptor-cardiac reflex function and causes orthostatic hypotension. Actual microgravity, however, has been shown to either increase, or not change vagal baroreflex gain.

Complexities of holistic community-based participatory research for a low income, multi-ethnic population exposed to multiple built-environment stressors in Worcester, Massachusetts.

Low income, multi-ethnic communities in Main South/Piedmont neighborhoods of Worcester, Massachusetts are exposed to cumulative, chronic built-environment stressors, and have limited capacity to respond, magnifying their vulnerability to adverse health outcomes. "Neighborhood STRENGTH", our community-based participatory research (CBPR) project, comprised four partners: a youth center; an environmental non-profit; a community-based health center; and a university. Unlike most CBPR projects that are single topic-focused, our 'holistic', systems-based project targeted five priorities.

A preliminary operational classification system for nonmutagenic modes of action for carcinogenesis.

This article proposes a system of categories for nonmutagenic modes of action for carcinogenesis. The classification is of modes of action rather than individual carcinogens, because the same compound can affect carcinogenesis in more than one way. Basically, we categorize modes of action as: (1) co-initiation (facilitating the original mutagenic changes in stem and progenitor cells that start the cancer process) (e.

The inter-observer reproducibility of Shafer's sign.

Pigment cells in the anterior vitreous (Shafer's sign) are known to be associated with retinal breaks. We sought to identify the reproducibility of Shafer's sign between different grades of ophthalmic staff. In all 47 patients were examined by a consultant vitreo-retinal surgeon, a senior house officer (SHO) and optician for Shafer's sign.

Ocular findings in low birthweight and premature babies in the first year: do we need to screen?

Purpose: There is no standardized approach for the ophthalmic care follow-up of children screened for retinopathy of prematurity (ROP). The authors report the ocular findings at 12 months in preterm and low birthweight babies screened for ROP over a 5-year period (1998-2003).

Methods: The case notes of 211 babies were retrospectively reviewed for birth details, maternal details, presence of ROP, and findings at follow-up screening which included visual acuity, refraction at 12 months, presence of squint, and any other ocular problems.

The radiation exposure compensation act: what is fair?

In 1990 the U.S. Congress passed a law providing compensation to former uranium miners who became ill while the U.