The (Gendered) Construction of Diagnosis Interpretation of Medical Signs in Women Patients

Medicine maintains a distinction between the medical symptom -- the patient'ssubjective experience and expression, and the privileged medical sign -- the objective findings observable by the doctor. Although the distinction is not consistently applied, it becomes clearly visible in the undefined, medically unexplained disorders of women patients. Potential impacts of genderized interaction on the interpretation of medical signs are addressed by re-reading the diagnostic process as a matter of social construction, where diagnosis results from human interpretation within a sociopolitical context. The discussion is illustrated by a case story and empirical evidence of the gendering in the doctor-patient relationship. The theoretical analysis is supported by semiotic perspectives of bodily signs, feminist theory on experience, and Foucault'sideas about medical perception and gaze, and concludes that a medical diagnosis is seldom a biological fact, but the outcome of a process where biological, cultural and social elements are interwoven. Further deconstruction of the chain of signs from a feminist perspective, assigning validity to the voice of the woman patient, might broaden the understanding of women'shealth, illness and disease.     

Long-term benefits of prompts to use safety belts among drivers exiting senior communities

Senior drivers are vulnerable to automobile crashes and subsequent injury and death. Safety belts reduce health risks associated with auto crashes. Therefore, it is important to encourage senior drivers to wear safety belts while driving. Using a repeated baseline design (AAB), we previously reported that motivating signs boosted safety belt usage by drivers exiting senior communities from baseline (72% and 68% usage), to postinstallation of signs (94%), to 6 months follow-up (80%). The current study was a 4-year follow-up in which six senior communities, with seat belt signs, were compared to six matched control senior communities with no signs. Safety belt usage was stable, across 4 years, at approximately 80% for both male and female drivers and front seat passengers for the six communities with signs, and was approximately 55% for control sites. These finding suggest that the simple and low-cost intervention of erecting signs to prompt safety belt use has persistent benefits that affect driver and passenger behavior alike.     

THE FAILURE OF FEEDBACK ON ALCOHOL IMPAIRMENT TO REDUCE IMPAIRED DRIVING

We examined the effects of rules to govern drinking, individual feedback on blood alcohol concentration (BAC), and public posting of group data on impaired driving on the incidence of impaired driving. Level of impairment was determined from breath samples taken from tavern patrons. Following baseline, an intervention package consisting of (a) cards to guide patrons in pacing their drinking to stay under the legal limit, (b) individual feedback on BAC, and (c) posted group feedback on the percentage of patrons driving while impaired the preceding week was introduced in two taverns. Results indicated that the intervention package did not reduce the percentage of impaired drivers departing either tavern. The addition of a brief intensive police enforcement program directed at impaired driving produced a short-term reduction in impaired driving.     

A replication of the use of public posting in traffic speed control

In an attempt to replicate several previous studies, a reversal design was used to assess the effects of publicly posted feedback on vehicle speed reduction. The intervention phases consisted of daily posted feedback that supplied drivers with either accurate or inaccurate information regarding the percentage of vehicles exceeding the speed limit on the road. Results from the two feedback conditions indicated no speed reduction in comparison to baseline levels. These results are discussed in light of previous studies that found strong effects for such feedback. Baseline levels of driver compliance and methodological differences may limit the effectiveness of posted feedback in reducing speeding.     

Effect of design factors on drivers’ understanding of variable message signs locating traffic events

BackgroundThis article addresses how to combine three elements (a pictogram, an arrow, a city) in a variable message sign (VMS) to locate temporary events (e.g., “congestion before Milan”). We adopted the G1c stack model as a design template, an Advanced Directional Sign (ADS) recommended by the 1968 Convention to locate cities, which can be easily adapted to modern VMS. However, as most of the VMS in operation are not full-matrix, we have also adapted this design to more restrictive display conditions. This adaptation critically concerned the arrow function on the message that either points up broadly (generically, as in G1c) or connects with the city more specifically (explicit). Although G1c reads top-down like a verbal text, previous studies indicated drivers’ preference for bottom-up landmark order in VMS, so both ordering criteria were compared in the present study.MethodsThe experiment involved 99 people (70 drivers and 29 drivers in training). Participants were informed that they would see various VMS reporting certain events (e.g., congestion) related to one of four cities along the road. Their task was to identify the event location (before, after the city) after seeing blocks of two consecutive messages (first a complementary message, then the target message), limiting their response to the content of the second message. Three design-focused factors were tested: typographical alignment (left or centre), landmark order (bottom-up or top-down), and arrow function (explicit or generic). The rate of correct location answers was the dependent variable.ResultsResults revealed that comprehension varied greatly depending on the arrow’s function and the placing of elements. In the explicit-arrow messages, comprehension was good both in the Top-down and Bottom-up conditions, but in the generic-arrow messages, only in the Bottom-up condition was comprehension good. Likewise, understanding was better in the Before condition than in the After condition in all combinations of Landmark order and Arrow function conditions. In general, left alignment of the central column elements of the VMS improved comprehension respective to centred alignment. Finally, the complementary message factor had an effect under certain circumstances.Practical implicationsThe messages displaying a generic arrow (following the G1c model) were better understood when the landmarks were ordered bottom-up, not top-down. In addition, explicit-arrow messages were better understood per se (in the absence of a complementary message) than generic-arrow messages. Overall, this work suggests that improving our understanding of how thought processes and design features relate to each other can contribute to safer driving nationally and internationally.     

Towards cultural psychology of affective processes: Semiotic regulation of dynamic fields

Abstract

The newly emerging interdisciplinary area of cultural psychology has largely addressed issues of conduct and cognition. A semiotic perspective is assumed here to investigate phenomena of affective self-regulation through signs. The phenomena of affect are presented as quasi-structured affective fields, which undergo differentiation through semiotic mediators (signs). The system of semiotic mediators is dynamic, self- constructive, and temporarily hierarchical. The function of the affective fields is that of orienting the person towards the immediate anticipated future. Semiotic regulation leads to the construction of hierarchical—yet temporary—structures of signs that constrain the experience. The crucial aspect of such regulation is the establishment of meta-level of operatory signs related to affective fields—for quick expansion of sign construction and for demolishing certain categories of signs. This dynamic guarantees the adaptability of the human psychological system, as signs allow for flexible expansion as well as limitations for subjective experiencing and action possibilities, in a given context. The new semiotic turn in psychology re-unites the concerns about the dynamic sides of behaving, feeling, and being through the focus on regulatory processes of the “stream of consciousness”.     

The effect of context and drivers’ age on highway traffic signs comprehension

Background: Comprehension of traffic signs is crucial to safety. Objectives: To test the effects of the presentation condition (with or without driving context) on symbolic based road signs comprehension and comprehension time for young and older drivers. Method: 50 young drivers and 50 older drivers were presented with images of 28 Israeli road signs, both without context (with a white background) and in context (with the driving surrounding). Data were collected on the accuracy of signs meaning and on the time it took the participants to provide the meaning. Results: Younger drivers performed significantly better than older drivers on both accuracy and response time (RT). Older drivers’ average RT was approximately twice as long as younger drivers’ RT. However, the presentation mode (with or without context) did not affect sign comprehension of either group, but the presence of the context did increase the time it took the drivers to comprehend the sign’s meaning. In addition, correct response time was similar to opposite to sign’s meaning response time. Implications: Older drivers, can benefit from retraining in sign comprehension of current signage. The training should involve signs in their natural road environment to reduce comprehension time while actually driving. Moreover, signs that were understood as having an opposite meaning should be redesigned or be accompanied by text.     

An Experimental Manipulation of Social Comparison in Social Anxiety

Negative self-appraisal is thought to maintain social anxiety particularly when comparing oneself to others. Work on social comparison suggests that gender may moderate the effects of social comparison in social anxiety. Self-appraisals of the desirability of one's personality may be more important to women, whereas self-appraisal of signs of anxiety may be more important to men. Within each gender, those with high social anxiety are expected to report more negative self-appraisal when comparing themselves to someone else described as high achieving. This study is the first we are aware of that examined gender-based interactive effects after a social comparison manipulation. Participants read a bogus profile of a fellow student's adjustment to college. They were randomly assigned to read a profile suggesting that the fellow student was “high achieving” or more normative in his/her achievements. When comparing to a “high achieving” individual, men with high social anxiety reported the most negative self-appraisals of their signs of anxiety. In addition, greater social anxiety was associated with a poorer self-appraisal of personality only among men. The implications of the findings for conceptualizing the role of social comparison in social anxiety are discussed.     

中医疗效的确定性与不确定性的比较思考

中医对于疾病的认识带有厚重的价值论色彩,昭示了强烈的主体尺度的特色。在辨证论治方面,它强调主体对于输出信息的价值判断,而非事实性认识;辨证论治标准的非客观化、非量化,会使不同主体在直觉体悟下产生不同的辨证结果,因而也就会产生不同的论治方法;中药饮片和中成药质量的现状也使中医经验的拷贝效果往往难以得到预想的重复。中医疗效表现出复杂的确定性与不确定性的矛盾。     

Evaluating public posting,goal setting,and rewards to increase physical activity during school recess

We evaluated a pedometer‐based intervention consisting of public posting between two teams of students, with additional self‐monitoring, goal setting, and reinforcement components, to increase physical activity during school recess. In the absence of self‐monitoring, performance feedback alone did not increase physical activity levels above those observed during baseline. Additionally, higher levels of physical activity were observed when goal‐setting was introduced, with the highest levels of activity observed when raffle tickets could be earned for exceeding a specified step‐total goal.