Reforming residency: modernizing resident education and training to promote quality and safety in healthcare

The goal of medical residency is to provide the best clinical education for future practice, while increasing quality and safety in current and future healthcare. This goal is not being met. Traditional residency programs often continue to utilize individually oriented, shame-and-blame approaches that do not recognize the systems nature of outcomes, care, and patient safety. Appropriate substantive methods, content, and training tools are also lacking, while residents continue to labor in a poor working environment. All these factors create a system that serves no one-not the resident, the patient, or the system in which both interact. Residency reforms are proposed to address these imperative concerns.     

How do voters form positive economic beliefs? Evidence from the Survey of Americans and Economists on the Economy

Beliefs about normative economics appear to be primarily determined by sociotropic rather than egocentric variables. (Sears & Funk, 1990; Citrin & Green, 1990) Using the Survey of Americans and Economists on the Economy, the current paper finds that the same holds for positiveeconomic beliefs in most – but not all – cases. This hinges on whether a question is “causal” or “non-causal”: Causal beliefs depend on sociotropic variables, especially education and ideology; non-causal beliefs, in contrast, depend on egocentric variables, with income growth playing the leading role. This is consistent with a cognitive model where actors answer easier questions using personal experience, and harder ones with ``off-the-shelf" theories.     

Women’s equality in Northern Ireland’s transition: intersectionality in theory and place

Women are invisible in mainstream analyses of the Northern Irish conflict. The prodigious literature is uninformed by gender analysis. These absences have discursive and material implications for tackling women’s inequality in a society in transition from armed conflict. Feminist intersectional theory counters and complicates essentialist constructions of identity. It aids understanding of the Northern Irish context by bringing into view issues of gender, sect and class. The tentative intersectional theoretical framework developed in this article is tested in an empirical study of women’s poverty. This supports the argument that intersectional analysis is required if the policy approach to women’s equality in Northern Ireland is to benefit the most marginalised women and thereby improve the prospects of building a more stable and peaceable society.     

Forensic handwriting examiners' expertise for signature comparison

This paper reports on the performance of forensic document examiners (FDEs) in a signature comparison task that was designed to address the issue of expertise. The opinions of FDEs regarding 150 genuine and simulated questioned signatures were compared with a control group of non-examiners' opinions. On the question of expertise, results showed that FDEs were statistically better than the control group at accurately determining the genuineness or non-genuineness of questioned signatures. The FDE group made errors (by calling a genuine signature simulated or by calling a simulated signature genuine) in 3.4% of their opinions while 19.3% of the control group's opinions were erroneous. The FDE group gave significantly more inconclusive opinions than the control group. Analysis of FDEs' responses showed that more correct opinions were expressed regarding simulated signatures and more inconclusive opinions were made on genuine signatures. Further, when the complexity of a signature was taken into account, FDEs made more correct opinions on high complexity signatures than on signatures of lower complexity. There was a wide range of skill amongst FDEs and no significant relationship was found between the number of years FDEs had been practicing and their correct, inconclusive and error rates.     

Injuries of the Head from Backface Deformation of Ballistic Protective Helmets Under Ballistic Impact

Modern ballistic helmets defeat penetrating bullets by energy transfer from the projectile to the helmet, producing helmet deformation. This deformation may cause severe injuries without completely perforating the helmet, termed “behind armor blunt trauma” (BABT). As helmets become lighter, the likelihood of larger helmet backface deformation under ballistic impact increases. To characterize the potential for BABT, seven postmortem human head/neck specimens wearing a ballistic protective helmet were exposed to nonperforating impact, using a 9 mm, full metal jacket, 124 grain bullet with velocities of 400–460 m/s. An increasing trend of injury severity was observed, ranging from simple linear fractures to combinations of linear and depressed fractures. Overall, the ability to identify skull fractures resulting from BABT can be used in forensic investigations. Our results demonstrate a high risk of skull fracture due to BABT and necessitate the prevention of BABT as a design factor in future generations of protective gear.     

An important failure: knowledge limits and the financial crisis

Abstract

This paper introduces a theme section on knowledge limits in and after the financial crisis. It explores how and why practitioners have generally responded less conservatively to crisis than academics, and argues that academics within a variety of problematics could do more by reflecting critically on the heroic ideas about the role of knowledge which were current across the social sciences in the decade before the crisis. It then turns to introduce the section's papers before finally raising the possibility of a more explicitly political approach to understanding finance.     

Following the News? Reception of Uncivil Partisan Media and the Use of Incivility in Political Expression

Partisan, pundit-based media gets blamed for making political discourse more uncivil, and studies on incivility in mediated discourse have found that uncivil political media can induce negative reactions in audiences. However, how use of uncivil media affects the way individuals express their political views has yet to receive substantial scholarly attention. I hypothesize that tuning in to uncivil political media leads to an increased propensity to use incivility in textual political expression. I develop an index to identify incivility in political expressions, and test my hypothesis using panel data analysis and an open-ended survey item in the 2008 National Annenberg Election Survey. I find that, consistent with my hypothesis, use of uncivil media—specifically pundit cable news and political talk radio—leads to an increased use of incivility when expressing text-based political opinions. Furthermore, this only occurs with reception of like-minded uncivil political media. I note the implications this has for online political discourse and effective deliberation.     

Eating Peas with One’s Fingers: A Semiotic Approach to Law and Social Norms

This paper proposes a semiotic theory of norms—what I term normative semiotics. The paper’s central contention is that social norms are a language. Moreover, it is a language that we instinctively learn to speak. Normative behaviour is a mode of communication, the intelligibility of which allows us to establish cooperative relationships with others. Normative behaviour communicates an actor’s potential as a cooperative partner. Compliance with a norm is an act of communication: compliance signals cooperativeness; noncompliance signals uncooperativeness. An evolutionary model is proposed to explain how this comes about: evolution has generated an instinctual proficiency in working with these signals much like a language—a proficiency that manifests in an emotional context. We see these social rules as possessing a certain ‘rightness’ in normative terms. This adaptive trait is what we call internalization. Internalization enhances the individual’s ability to speak this code. Because these signals communicate who is and who is not a reliable co-operator, sending and receiving cooperation signals is crucial to individual survival. Individuals who internalized the entire process and thus became more adept at speaking the language were at an advantage. Law seeks to shape the language of norms by maintaining the collective standards of society; as such, understanding how and why this normative language emerges is critical to understanding a core function of law.     

Mobilizing Law in Latin America: An Evaluation of Black's Theory in Brazil

This research addresses two separate but related questions. First, to what extent are sociological theories proposed to explain legal behavior in Western societies applicable to non‐Western contexts? And second, to what degree is Black's theory of law generalizable, as he contends, “across time and space?” Our research merges these questions by exploring the applicability of Black's theory in a Latin American context. Data collected from a nationally representative survey in Brazil suggest support for Black's propositions regarding the impact of vertical, horizontal, cultural, and normative status on the likelihood of mobilizing the law, as well as the feasibility of using his framework for understanding legal behavior in non‐Western settings. Our discussion considers implications and directions for future analyses in both the Brazilian and cross‐cultural contexts.