Search

Culture and social structure are not separated analytical domains but intertwined phenomena observable in personal networks. Drawing on a personal networks dataset of migrants in the United States and Spain, we show that the country of origin, a proxy for diverse languages and cultural institutions, and religion may be predicted by specific combinations of personal network structural measures (closeness, clustering, betweenness, average degree, etc). We obtain similar results applying three different methods (a multinomial logistic regression, a Random Forest algorithm, and an artificial neural network). This finding is explained within the framework of the Grid/Group theory that has long posed the interdependence of social structural and cultural features of human groups., (© The Author(s) 2022. Published by Oxford University Press on behalf of National Academy of Sciences.)

Sample size determination for open-ended questions or qualitative interviews relies primarily on custom and finding the point where little new information is obtained (thematic saturation). Here, we propose and test a refined definition of saturation as obtaining the most salient items in a set of qualitative interviews (where items can be material things or concepts, depending on the topic of study) rather than attempting to obtain all the items. Salient items have higher prevalence and are more culturally important. To do this, we explore saturation, salience, sample size, and domain size in 28 sets of interviews in which respondents were asked to list all the things they could think of in one of 18 topical domains. The domains-like kinds of fruits (highly bounded) and things that mothers do (unbounded)-varied greatly in size. The datasets comprise 20-99 interviews each (1,147 total interviews). When saturation was defined as the point where less than one new item per person would be expected, the median sample size for reaching saturation was 75 (range = 15-194). Thematic saturation was, as expected, related to domain size. It was also related to the amount of information contributed by each respondent but, unexpectedly, was reached more quickly when respondents contributed less information. In contrast, a greater amount of information per person increased the retrieval of salient items. Even small samples (n = 10) produced 95% of the most salient ideas with exhaustive listing, but only 53% of those items were captured with limited responses per person (three). For most domains, item salience appeared to be a more useful concept for thinking about sample size adequacy than finding the point of thematic saturation. Thus, we advance the concept of saturation in salience and emphasize probing to increase the amount of information collected per respondent to increase sample efficiency., Competing Interests: The authors have declared that no competing interests exist.

Background: Despite the widespread popularity of social media, little is known about the extent or context of pain-related posts by users of those media., Objective: The aim was to examine the type, context, and dissemination of pain-related tweets., Methods: We used content analysis of pain-related tweets from 50 cities to unobtrusively explore the meanings and patterns of communications about pain. Content was examined by location and time of day, as well as within the context of online social networks., Results: The most common terms published in conjunction with the term "pain" included feel (n=1504), don't (n=702), and love (n=649). The proportion of tweets with positive sentiment ranged from 13% in Manila to 56% in Los Angeles, CA, with a median of 29% across cities. Temporally, the proportion of tweets with positive sentiment ranged from 24% at 1600 to 38% at 2400, with a median of 32%. The Twitter-based social networks pertaining to pain exhibited greater sparsity and lower connectedness than did those social networks pertaining to common terms such as apple, Manchester United, and Obama. The number of word clusters in proportion to node count was greater for emotion terms such as tired (0.45), happy (0.43), and sad (0.4) when compared with objective terms such as apple (0.26), Manchester United (0.14), and Obama (0.25)., Conclusions: Taken together, our results suggest that pain-related tweets carry special characteristics reflecting unique content and their communication among tweeters. Further work will explore how geopolitical events and seasonal changes affect tweeters' perceptions of pain and how such perceptions may affect therapies for pain.

A recent poll showed that most people think of science as technology and engineering--life-saving drugs, computers, space exploration, and so on. This was, in fact, the promise of the founders of modern science in the 17th century. It is less commonly understood that social and behavioral sciences have also produced technologies and engineering that dominate our everyday lives. These include polling, marketing, management, insurance, and public health programs.

This paper examines the association of women's social networks with the use of skilled birth attendants in uncomplicated pregnancy and childbirth in Matlab, Bangladesh. The network-episode model was applied to determine if network structure variables (density/kinship homogeneity/strength of ties) together with network content (endorsement for or against a particular type of birth attendant) explain the type of birth attendant used by women above and beyond the variance explained by women's individual attributes. Data were collected by interviewing a representative sample of 246 women, 18-45 years of age, using survey and social network methods between October and December 2008. Logistic regression models were used to examine the associations. Results suggest that the structural properties of networks did not add to explanatory value but instead network content or the perceived advice of network members add significantly to the explanation of variation in service use. Testing aggregate network variables at the individual level extends the ability of the individual profile matrix to explain outcomes. Community health education and mobilization interventions attempting to increase demand for skilled attendants need to reflect the centrality of kinship networks to women in Bangladesh and the likelihood of women to heed the advice of their network of advisors with regard to place of birth., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Estimating sizes of hidden or hard-to-reach populations is an important problem in public health. For example, estimates of the sizes of populations at highest risk for HIV and AIDS are needed for designing, evaluating and allocating funding for treatment and prevention programmes. A promising approach to size estimation, relatively new to public health, is the network scale-up method (NSUM), involving two steps: estimating the personal network size of the members of a random sample of a total population and, with this information, estimating the number of members of a hidden subpopulation of the total population. We describe the method, including two approaches to estimating personal network sizes (summation and known population). We discuss the strengths and weaknesses of each approach and provide examples of international applications of the NSUM in public health. We conclude with recommendations for future research and evaluation.

Objectives: We tested competing hypotheses for the skin color-blood pressure relationship by analyzing the association between blood pressure and 2 skin color variables: skin pigmentation and social classification., Methods: We measured skin pigmentation by reflectance spectrophotometry and social classification by linking respondents to ethnographic data on the cultural model of "color" in southeastern Puerto Rico. We used multiple regression analysis to test the associations between these variables and blood pressure in a community-based sample of Puerto Rican adults aged 25-55 years (n=100). Regression models included age, gender, body mass index (BMI), self-reported use of antihypertensive medication, and socioeconomic status (SES)., Results: Social classification, but not skin pigmentation, is associated with systolic and diastolic blood pressure through a statistical interaction with SES, independent of age, gender, BMI, self-reported use of antihypertensive medication, and skin reflectance., Conclusion: Our findings suggest that sociocultural processes mediate the relationship between skin color and blood pressure. They also help to clarify the meaning and measurement of skin color and "race" as social variables in health research.

The authors have developed and tested scale-up methods, based on a simple social network theory, to estimate the size of hard-to-count subpopulations. The authors asked a nationally representative sample of respondents how many people they knew in a list of 32 subpopulations, including 29 subpopulations of known size and 3 of unknown size. Using these responses, the authors produced an effectively unbiased maximum likelihood estimate of the number of people each respondent knows. These estimates were then used to back-estimate the size of the three populations of unknown size. Maximum likelihood values and 95% confidence intervals are found for seroprevalence, 800,000 +/- 43,000; for homeless, 526,000 +/- 35,000; and for women raped in the last 12 months, 194,000 +/- 21,000. The estimate for seroprevalence agrees strikingly with medical estimates, the homeless estimate is well within the published estimates, and the authors' estimate lies in the middle of the published range for rape victims.

After becoming alarmed about seven unusual and severe complications reported by New York State hospitals after laparoscopic cholecystectomy, the Department of Health of New York State tabulated all reported adverse incidents. After observing unusual injuries to the great vessels of the abdomen and an increase in major bile duct injury during laparoscopic cholecystectomy, the Department of Health prepared a memorandum to New York State hospitals advising closer attention to education, credentialing, proctoring, and outcome after these operations. The frequency of cholecystectomy has increased sharply, by 21%, since the advent of laparoscopic cholecystectomy. The serious injury rate may be approximately 15 times that observed after an open cholecystectomy. Recognizing the theoretic advantages of the procedure, the Department of Health reminded hospital Boards of Trustees of their obligation to establish mechanisms for credentialing and privileging surgeons and surgical teams so that the risks do not exceed those expected of the open procedure and to detect and correct deviations from this standard.

This study uses New York State hospital discharge data to examine the relationship between in-hospital mortality for a patient receiving an abdominal aortic aneurysm resection and the volume of aneurysm operations performed in the previous year at the hospital where the operation took place and by the surgeon performing the operation. Previous research on this topic is extended in several respects: (1) A three-year data base is used to examine the manner in which hospital and surgeon volume jointly affect mortality rate and to examine ruptured and unruptured aneurysms separately; (2) a six-year data base is used to study the "practice makes perfect" hypothesis and the "selective referral" hypothesis; and (3) the degree of specialization of high-volume surgeons is contrasted with that of other surgeons. The results demonstrate a significant inverse relationship between hospital volume and mortality rate for unruptured aneurysms. Further, very few surgeons substantially increased their aneurysm surgery volumes in the six-year study period. Weak selective referral effects were found for both surgeons and hospitals, and higher-volume aneurysm surgeons tended to have much higher specialization rates.

This study utilized a state-wide data base containing clinical risk factors for cardiac surgery to investigate differences in in-hospital mortality rates for men and women undergoing coronary artery bypass surgery. The crude mortality rates for coronary artery bypass surgery for men and women were 3.08% and 5.43% respectively, in New York State in 1989. When logistic regression analysis was used to control for preoperative risk, gender remained a significant predictor of mortality. Risk-adjusted (indirectly standardized) mortality rates were 3.33% and 4.45% for men and women, respectively. The risk-adjusted odds ratio of women to men experiencing in-hospital death was 1.52 (95% confidence interval 1.25 to 1.90).

Two cases are presented of short bowel syndrome. Both had had the colon or part of the colon bypassed as part of prior surgical management in addition to having had extensive resection of the small bowel. Despite various medical regimens, both patients remained in negative fluid and electrolyte balance thus requiring intravenous fluid supplementation. In an effort to maintain positive fluid balance without intravenous therapy, colonic infusion of fluids was initiated. This modification of management proved effective in maintenance of adequate plasma volume and normal renal function. It is concluded that this type of therapy can be of great benefit in the management of patients with the short bowel syndrome.

To study the isolated effects of decreased hemoglobin concentration without volume loss, eight patients with the diagnosis of polycythemia were studied following acute phlebotomy and simultaneous volume replacement. These patients had been treated previously by repeated phlebotomy, without volume replacement, to a hemoglobin level of 14.8 +/- 0.5 gm%. Following hemodilution by additional phlebotomy and volume replacement, which further lowered the mean hemoglobin level to 11.4 +/- 0.4 gm%, cardiac index increased significantly from 2.8 +/- 0.3 to 3.5 +/- 0. 3 liter/min/m(2) (P<0.05), oxygen delivery did not change, but total body oxygen consumption increased significantly from 140 +/- 16 to 180 +/- 15 ml/min/m(2) (P<0.05). Mixed venous PO2, systemic and pulmonary vascular resistance decreased significantly (P<0.05). Vascular pressure, heart rate, intrapulmonary shunt, arterial pH and bicarbonate, limb blood flow, limb oxygen delivery and limb oxygen consumption did not change. Thus, with phlebotomy and fluid replacement, a reduction of hemoglobin concentration to a subnormal level increased oxygen consumption without lowering oxygen delivery.

We tested the efficacy of selected case characteristics in targeting quality of care problems for medical record review. The case characteristics, all of which apply to patients who die in a hospital, consist primarily of procedures and DRGs (diagnosis-related groups) for which death rarely occurs, and a set of complications of surgical care. All characteristics are obtainable from combinations of the principal and secondary diagnoses and procedures in the case, and are available from discharge abstracts. The presence of a quality of care problem is confirmed through a review of the medical record by a nurse and two or more physicians. A logistic regression model that controls for various patient and hospital variables is used as a measure of each of the proposed case characteristics. The results indicate that most of the characteristics are associated with higher percentages of quality of care problems than cases chosen at random, and that the methodology has promise as a tool for targeting cases for medical record review.

Recent studies have demonstrated that the number of times a hospital or surgeon performs certain procedures annually has an inverse relationship with in-hospital mortality rates for patients undergoing the procedures. This study uses an improved measure of physician volume to test the combined relationship of hospital and physician volume with in-hospital mortality rates and to explore the existence of threshold volumes that optimally discriminate high- and low-volume providers. Five procedure groups have significant volume-mortality relationships. For total cholecystectomies, hospital volume is the more significant volume measure, but physician volume is marginally related to mortality rate. For coronary artery bypass surgeries, resection of abdominal aortic aneurysms, partial gastrectomies, and colectomies, physician volume is more significant than hospital volume, but hospital volume is marginally significant. Annual hospital volume thresholds for these data appear to exist at approximately 5 procedures for partial gastrectomies, 40 procedures for colectomies, and 170 procedures for total cholecystectomies.