bluuebunny/crossref_metadata_2025 huggingface dataset:
Field Investigations From the State and Local Health Department Perspective
Authors: Davis Jeffrey P. , Birkhead Guthrie S.
Published: September 2009

Working and networking diligently with colleagues and appropriately communicating ideas and information across jurisdictional lines and between scientific disciplines are keys to the success of state and local field epidemiologic activities. However, epidemiologists should be aware of certain critical factors that can provide new insights into the conduct of even the most routine investigations and related activities. This chapter presents a framework for investigations in this field and discusses issues in state and local surveillance. The conduct of field epidemiologic investigations and surveillance activities by state and local health department staff and their partners occurs within a framework that involves: understanding state and local laws and codes; awareness of personnel and resource constraints; effective collaboration, networking, and information sharing; maximizing information transfer and appropriate incorporation of technologic advances; sensitivity to local, state, and federal political issues that are germane to field epidemiologists; and cooperative and productive working relationships using print and electronic media.
Field Investigations of Natural Disasters and Complex Emergencies
Authors: Waldman Ron , Noji Eric K.
Published: September 2009

This chapter discusses field investigations of disasters and emergencies. Topics covered include the historical development of field epidemiology in disasters and emergencies, role of the epidemiologist in disaster response, problems faced in the field, rapid quantitative needs assessment, and surveys.
Laboratory Suppport for the Epidemiologist in the Field
Authors: Gunter Elaine W. , Knapp Joan S. , Nicholson Janet K. A.
Published: September 2009

This chapter provides general guidelines on what specimens are appropriate to collect when investigating an infectious disease problem or when studying a potentially toxic chemical or radionuclide exposure, and what types of tests should be done to confirm an exposure or infection.
Toward a Philosophy of Epidemiology
Authors: Weed Douglas L.
Published: September 2009

This chapter explores the need for and nature of philosophy in epidemiology. It requires the collaboration of epidemiologists and philosophers who seek to uncover the foundations of this basic professional health discipline. The chapter begins with some history, documenting the extent to which a few epidemiologists and even fewer philosophers are already moving toward a philosophy of epidemiology. It identifies the three levels of interaction possible between philosophy and epidemiology: philosophy and epidemiology, philosophy in epidemiology, and philosophy of epidemiology.
Privacy and Confidentiality in Epidemiology: Special Challenges of Using Information Obtained without Informed Consent
Authors: Clayton Ellen Wright
Published: September 2009

This chapter addresses the following questions: What values underlie privacy and confidentiality and what consequences follow from their breach? What values justify intrusion upon privacy and confidentiality without consent? Under what circumstances and by whom? How are these decisions to be made? What personal information can be disclosed? When? To whom? The values of individual privacy, confidentiality, and public goods cannot always be reconciled, so trade-offs are often required. The laws and regulations that address these issues are considered, identifying some of the ways in which they conflict with or fail to address these ethical issues.
Ethics in Public Health Practice
Authors: McKeown Robert E. , Learner R. Max
Published: September 2009

This chapter outlines a perspective that can serve as a foundation for addressing ethical concerns in public health practice. It argues that ethics in public health practice is shaped by the mission of public health and that the ethical obligations of public health practitioners are grounded in their commitment to that mission and in their voluntary assumption of responsibility for the public's health. Society also has an interest in the public's health and that endorsement provides partial justification for infringing on certain individual rights for the sake of the common good. Though public health ethics is not as highly developed as clinical ethics, research ethics, or other subfields of bioethics, recent developments have made clear that it must make use of bioethical methods and concepts and incorporate ethical reasoning in decision-making processes. The resulting public health ethics will include expanded or modified concepts of justice and respect for persons, human rights, communitarianism, utilitarianism, and virtue ethics.
Ethical Issues in Genetic Epidemiology
Authors: Beskow Laura M. , Burke Wylie
Published: September 2009

This chapter examines three selected issues that, although not unique to genetics, are becoming increasingly important in genetic epidemiology: federal policies for widespread data sharing, the use of “race” as a variable in research involving genetics, and concepts of community engagement. These issues are interrelated and represent areas of tension between participant protection and the quality and efficiency of research.
Ethical Issues in International Health Research and Epidemiology
Authors: Porter John D. H. , Stephens Carolyn , Kessel Anthony
Published: September 2009

This chapter explores the ethical issues that arise in the course of undertaking epidemiological and international health research, focusing on ethical issues that the researcher inevitably has to grapple with during the conduct of research. These include how to plan and develop international research, the value systems of different cultures and countries, particular issues in low-income countries such as those around priority-setting, equity, and consent, external sponsorship and ethical review of research, and what happens when the research is over. It argues that although following guidelines and adhering to the law are both important, it is critical that the researcher approaches the research with an open mind and willing heart. There is no replacement whatsoever for thoughtfulness, sensitivity, and treating people with respect and dignity.
The Institutional Review Board
Authors: Levine Robert J.
Published: September 2009

This chapter describes the committees responsible for reviewing proposals to conduct research involving humans as subjects to determine whether they include adequate safeguards of the rights and welfare of the research subjects. These committees, generally called institutional review boards (IRBs), now exist in many locales in most countries. National regulations in an increasing number of countries and the leading international codes of research ethics establish the requirement that research involving humans as subjects, with few exceptions, may not be carried out without review and approval of these committees; hence their importance to epidemiologists. The history, composition, organizational settings, purposes of these committees, and major themes in contemporary controversies about them are discussed.
Ethics Curricula in Epidemiology
Authors: Goodman Kenneth W. , Prineas Ronald J.
Published: September 2009

Since the mid-1990s epidemiology has joined other sciences and health professions in making ethics education a component of the larger curriculum. However, the change is far from total. Many programs and schools continue to include ethics only episodically, if at all. This chapter argues that developments in epidemiology and ethics have attained such importance that they continue to merit (1) development of new course materials, (2) training of appropriate faculty members, and (3) integration of new courses into epidemiology, public health, and other curricula. Ongoing efforts to include ethics-and-epidemiology sessions in professional conferences should also be expanded, and short courses, perhaps on special topics or problems, should be developed for students, practitioners, and university faculty.
History, Narrative, and Sexual Identity
Authors: Shepard Benjamin
Published: September 2009

This chapter reviews competing narratives of queer sexuality during the postwar years. It begins with the intermingling Cold War red and lavender scares over communism and sexual perversion, juxtaposed with calls for civil tolerance of homosexuals by the Mattachine Society and other early homophile groups in the 1950s. By the 1960s, narratives had shifted from treatment of homosexuals as second-class citizens—based on criminal and mental illness models—toward civil rights discourses centered on citizenship. By the 1970s, narratives had shifted toward a more assertive call for personal and sexual freedom. With the dawn of the acquired immune deficiency syndrome (AIDS) pandemic in the 1980s, narratives of gay life shifted once again, as homosexuality was again linked with images of illness. By the 1990s, panic narratives had become part of the ongoing debates about AIDS, sex, and pleasure as conservative and radical camps debated the contemporary meanings of queer sexuality.
Unity and Purpose at the Intersections of Racial∕Ethnic and Sexual Identities
Authors: Meyer Ilan H. , Ouellette Suzanne C.
Published: September 2009

This chapter addresses the question: How do Black lesbians, gay men, and bisexuals (LGBs) who inhabit two socially significant identities, experience these identities? It considers two dominant perspectives in identity theory. One perspective views multiple salient identities as competing; the other perspective argues that multiple identities coexist to form a coherent self. It supplements these perspectives with two notions: (1) that individuals recognize the social origin of constraints placed on their identities; and (2) that identity is a dialectical process that occurs in distinctive interpersonal, sociocultural, and historical contexts. This conceptual framework shows how unity can exist alongside multiplicity and personal agency alongside social determination in Black LGB identities.
Bisexuality in a House of Mirrors
Authors: Rust Paula C. Rodríguez
Published: September 2009

This chapter uses the concept of identity as a narrative product to explore the microconstructive processes that bisexual individuals go through as they move among the various social and cultural environments of their daily lives and life courses. The data on which this chapter is based are taken from the International Bisexual Identities, Communities, Ideologies, and Politics study (IBICIP)—a self-administered survey of individuals who had ever identified themselves as bisexual and/or had ever been attracted to or had sexual contact with at least one person of the same sex over the course of their lives. The chapter focuses on individuals who reported more than one sexual identity and examines the ways in which these different identities allow them to function in the different cultural environments within which they live, work, and socialize.
Narrative Identity Construction of Black Youth for Social Change
Authors: Blackburn Mollie V.
Published: September 2009

This chapter begins by discussing how narratives, and counternarratives in particular, function in both emotive and ethico-political ways. It considers the narrative resources upon which a teller draws, such as coherence, multiplicity, and variability. It then examines scholarship on analyzing repeated telling before moving to one particular individual's repeated tellings of her narrative, which is analyzed in terms of functions, factors, and resources. The chapter argues that when narratives that function both emotively and ethico-politically are repeated in different contexts, for different audiences, and with different intents, the tellers have opportunities to draw on multiplicity and variability as they move from incoherence to coherence, and thus they have great potential to work for social change.
Between Kansas and Oz
Authors: Kurtz Steven P.
Published: September 2009

This chapter describes how gay men attempt to locate themselves in an environment in which change, spectacle, and the search for altered states of being are the main constants. It draws on extensive qualitative data collected over a decade to trace patterns in the narratives that gay men use to describe their experiences as they absorb and sometimes separate from the sex-drug pleasure dome that Miami is often seen to represent. The chapter presents the story of how men from diverse backgrounds integrate the sense of themselves as developed throughout childhood and adolescence (“Kansas”) into this urban space that for most of them feels like “Oz”.
The Role of the Internet in the Sexual Identity Development of Gay and Bisexual Male Adolescents
Authors: Harper Gary W. , Bruce Douglas , Serrano Pedro , Jamil Omar B.
Published: September 2009

This chapter examines the role of the Internet in the sexual identity development process of gay and bisexual male adolescents. These adolescents reported using a range of Internet applications (Web sites, discussion boards, IM, email, etc.) that provided them with varying degrees of anonymity and connection to others. A youth's comfort with and acceptance of his sexual identity often influenced both his use of the various Internet modalities and the degree to which he revealed personal information during these interactions. The participants' narratives revealed that their use of the Internet and its applications could be categorized into four increasing levels of connection with other people: (1) anonymous exploration, (2) casual posting, (3) online conversations, and (4) offline meetings.
Midlife Lesbian Lifeworlds
Authors: Read Mary M.
Published: September 2009

This chapter uses narrative identity theory to describe and facilitate an understanding of issues regarding the formation of a positive lesbian identity among a particular cohort of women: midlife North American lesbian women who were born between approximately 1940 and 1965. The life experiences and recollections of North American lesbians of the baby boom cohort reflect the integration of multiple aspects of the self, continually emerging and re-forming across diverse settings. The goal of the chapter is to display the narrative identity processes midlife lesbians—who experience at least three forms of diminished privilege in North American society (being women, older, and of stigmatized sexual orientation)—have used to create lives of meaning and fulfillment. These issues are explored through the lens of a conceptual model created by analyzing narrative data gathered from life story portions that were available in existing literature.
From Same-Sex Desire to Homosexual Identity
Authors: Rosenfeld Dana
Published: September 2009

This chapter presents a study that examined the range of self-identified lesbian and gay elders' identity practices. The research is based on open-ended, in-depth interviews, each lasting for 2-3 hours, conducted in 1995 with thirty-five self-identified gay men and women aged 65 and over living in the greater Los Angeles area. The study showed patterns in these identity practices, grounded in the discourses of homosexuality that prevailed in the 20th century and in the specific discourse of homosexuality through which informants had crafted their sexual identities.
God in the Courtroom
Authors: Bornstein Brian , Miller Monica
Published: September 2009

The phrase “God in the courtroom” conjures up several images, such as William Jennings Bryan defending religion against the tyranny of evolution, a robed deity passing divine judgment, a witness swearing to tell “the truth, the whole truth, and nothing but the truth, so help me God,” and so on. But there are numerous other, often subtle ways in which religion and law intersect. This book reviews legal developments and behavioral science research concerning the effects of religion on legal practice, decision making processes of various legal actors, and trial outcomes. For example, religious beliefs might influence the decisions of legal decision makers, such as judges and jurors. Attorneys might rely on religion, both in the way they approach their professional practice generally and in specific trial tactics (e.g., using a scriptural rationale in arguing for a particular trial outcome). This book covers these and related topics in exploring how religion affects the actions of all of the major participants at trial: jurors, judges, attorneys, and litigants.
Chapter 7 Music in Urban Space
Authors: Wegner Gert-Matthias
Published: September 2009

Newar culture is arguably the most complex urban culture in the Himalayan region. Several occupational castes observe specific musical duties in accordance with the ritual calendar and during the big town rituals. This chapter examines how the processional music of the Buddhist Bajrācarya, Sākya, and Sāymi castes relates to urban space in the Newar town of Bhaktapur in the Kathmandu Valley and highlights the significance of ritual and the locality in such performances.
Genovefa’s Territory
Authors: Bitel Lisa M.
Published: September 2009

This chapter recounts the life of Genovefa (Saint Geneviève) from her birth at Nanterre ca. 420 to her death ca. 509 in Paris, as told by her earliest 6th-century biographer. Although a woman, and thus limited in ecclesiastical authority, Genovefa acted much like a Christian bishop. She was most famous for building the shrine of Saint Denis, supposedly the first missionary to Paris. Her building projects and her written biography taught Christians lessons about saints, bishops, and religious landscapes.
Relics
Authors: Bitel Lisa M.
Published: September 2009

This chapter tracks the cults of Genovefa and Brigit up to the present day in order to account for the endurance of their cults and show what the histories of these two saints can tell us about historical connections between landscape, gender, and religious change. Conversion did not occur merely as a result of missionary preaching, but because many women and men chose to go to new kinds of religious places, use new kinds of symbolic goods, and reinterpret their daily habits in religious context. Denied episcopal office because of their sex, Genovefa and Brigit helped bring Christianity to northern Europe at the dawn of the Middle Ages by promoting such changes in lived religion and, in particular, by sponsoring religious architecture and new uses of familiar sacral places in their home territories.
12 The Gendered Cycle of Vulnerability in the Less Developed World
Authors: Marion Young Iris
Published: September 2009

This chapter seeks to extend Okin's powerful account of how the interaction of gender relations in the family with gendered norms of workplaces reinforces women's vulnerability. While Okin's own argument focused on the situation of women in the United States, this chapter argues that the basic structural logic of the gendered cycle of vulnerability also describes relations that condition and constrain the lives of many women in at least some less developed countries.
1 Okin's Liberal Feminism as a Radical Political Theory
Authors: Rosenblum Nancy
Published: September 2009

This chapter discusses the radical implications of Susan Okin's liberal political philosophy. Most of the world's societies subject women to unequal lives, whether through laws or conventions or a combination of the two. Rosenblum argues that this subjection of women is the touchstone of Okin's liberal humanism. Drawing out the similarities between Okin and John Stuart Mill, Rosenblum shows how his touchstone issues result in some radical theoretical and practical commitments.
3 Of Linchpins and Other Interpretive Tools
Authors: Wingrove Elizabeth
Published: September 2009

This chapter argues that Okin's “method”—her focus on actual social problems—has been largely ignored in the literature. The author of this chapter contends that examining Okin's method can help us understand some of the strengths of her work—its relevance, its ability to hone in on matters of importance—as well as throw light on its shortcomings. Because Okin eschewed engagement with method, this chapter claims that she was insufficiently aware of her own biases and assumptions. The chapter illustrates this claim by looking at Okin's writings on multiculturalism and on the family.
4 Can Feminism Be Liberated from Governmentalism?
Authors: Tomasi John
Published: September 2009

This chapter contrasts two concepts of feminism: a feminism that embraces institutions such as the government as agents of social change and a feminism that is skeptical about or even hostile toward such institutions. This chapter discusses a group of anti‐governmental feminists from the late 19th century, including Sarah Grimké, Angela Fiducia Tilton Heywood, and Lillian Harman, and defends their approach to women's subjection over that of “governmentalists” like Susan Okin.
5 Equality of Opportunity and the Family
Authors: Miller David
Published: September 2009

Noting that Okin placed the family at the center of concerns about justice, this chapter explores the relationship between the family and the achievement of equality of opportunity. The chapter contrasts several conceptions of equality of opportunity and explores each conception's ability to accommodate the family. It also discusses the possibility of reconciliation between the family and equality of opportunity in the light of the social science literature on intergenerational transmission of inequality.
6 “No More Relevance than One's Eye Color”
Authors: Lyndon Shanley Mary
Published: September 2009

To what extent would sex, in a just society, be like eye color—an irrelevant personal feature with little significance? Okin made the parallel in her writings; this chapter explores and contests that parallel. This chapter explores Okin's goal of abolishing gender, given her analysis of the pernicious effects of the gender system on women. The chapter calls for an agnosticism about Okin's project, arguing that sex will continue to matter to people in the future and that we cannot know how future people will link sex to some concept of gender as an identity.
8 What We Owe Women
Authors: Shachar Ayelet
Published: September 2009

This chapter explores the policy implications of the feminist critique of multiculturalism. According to this chapter, there are three variants of that critique—liberal, postcolonial, and multicultural—with different implications for public policies. Actual cases—including Shari'a tribunals in Israel and Canada—are used to reveal the strengths and weaknesses of the different approaches.
10 The Dilemma of a Dutiful Daughter
Authors: Kukathas Chandran
Published: September 2009

This chapter uses the life of a Javanese woman at the end of the 19th century to explore the tensions between individual freedom and familial loyalty. In particular, it shows that although Kartini had the freedom to leave her family and shake off cultural expectations about women's role, she was ultimately unwilling to do so. The chapter argues that Kartini's dilemma tells against Okin's own proffered solution to the liberation of women from constricting cultures: state intervention to provide education. Kartini had an education, she had a desire to pursue her own goals, she had the resources to do so, and she had parental approval. What she did not have, The chapter concludes, was the social milieu that would allow her to pursue those ambitions and still enjoy both the approval of the community and a clear conscience.
11 Discordant Cooperation
Authors: Keohane Robert O.
Published: September 2009

This chapter builds on Susan Okin's deep commitment to gender equality, exploring whether globalization can be “reinvented” in a way that would help to promote gender equality in developing countries. This chapter argues that feminist social movements are wise not to reject globalization but to use the opportunities it provided to promote gender equality. This chapter differentiates among institutions that may be more or less open to change. In particular it argues that the World Bank has shown itself to be more open to change than some other global institutions, and feminists might do well to engage it while at the same time maintaining a healthy critical distance from it.
The Novelty of Newspapers
Authors: Rubery Matthew
Published: September 2009

This book explains why the Victorian novel is best understood alongside the simultaneous development of the news as a commercial commodity read by up to a million readers per day. The commercial press arising in 19th-century Britain had a profound influence on the fiction of Mary Braddon, Charlotte Brontë, Wilkie Collins, Charles Dickens, Joseph Conrad, Henry James, Anthony Trollope, and many other novelists who all used narrative conventions derived from the press in their fiction. The chapters of this book distinguish five of the most important of these narrative conventions—shipping intelligence, personal advertisements, leading articles, interviews, and foreign correspondence—in order to show how concretely journalism influenced the novel at this time. This book thereby challenges the assumed divide between the period's literature and journalism, with all of its implications for the production of an idea of culture and hierarchies of reading, by demonstrating how the daily newspaper was integral to the Victorian novel's development—what this book calls “the novelty of newspapers”.
The Shipping Intelligence
Authors: Rubery Matthew
Published: September 2009

Nowhere is the borrowing from newspapers by novelists so clear as in the case of shipwrecks, the most frequently reported disaster in the Victorian press. This chapter shows that novelists used this wildly popular feature drawn from the pages of Lloyd's List to highlight the impact news could have on domestic life. Although the shipping news has often been regarded as an exclusively male interest of sailors, merchants, and investors, this section of the newspaper was read with equal fervor by domestic women separated by the sea from loved ones. We know this through a remarkable sequence of parallel scenes across the 19th-century novel in which the revelation of private love takes place at the moment when the newspaper ensures that the heroine's admiration will be shared by all of England. Novelists as different as Wilkie Collins, Charles Dickens, Robert Louis Stevenson, Bram Stoker, and Charlotte Yonge all recognized the counterintuitive way in which public media enabled the expression of private feeling, a response strikingly evident on dramatic occasions such as the loss of a ship at sea. Such scenes vividly illustrate a new approach to understanding catastrophe in Victorian fiction.
The Personal Advertisements
Authors: Rubery Matthew
Published: September 2009

This chapter looks at the reading communities formed through the personal advertisements on the newspaper's front page. Its second column came to be known in the late 19th century as the “agony column” for its emphasis on personal distress, ranging from pathetic tales of runaway husbands to plaintive cries for attention from lonely hearts. Such heartfelt pleas did not escape the attention of the school of sensation novelists, who were quick to capitalize on the criminal possibilities of the most interactive section of the newspaper through an improbable number of phony marriage announcements, misreported obituaries, and unanswered missing-persons inquiries among their fictional narratives. Wilkie Collins's The Woman in White, Ellen Wood's East Lynne, and Mary Braddon's Lady Audley's Secret illustrate how the newspaper could be used to begin a second life. The misuse of advertisements in these novels taps into the at-once stimulating and disturbing implications of anonymity in modern life brought within everyone's reach through the daily press. Audiences were not just reading about other people's lives in the newspaper. They were using the newspaper to change their own.
The Personal Interview
Authors: Rubery Matthew
Published: September 2009

The interview was first used in the United States in the 1860s and in Britain in the 1880s. No longer limited in meaning to a conversation between two people, the term “interview” acquired its familiar modern meaning as a conversation directed toward an absent third party. Henry James, for whom journalism had always been an invasion of privacy, wrote in his notebooks at this time of “the devouring publicity of life, the extinction of all sense between public and private” associated with the new methods of personal journalism. Yet James's novels address people's unexpected willingness to share their most intimate experiences with the journalist in a way that ran counter to the author's own preference for impersonal narration. The discussion of James's The Reverberator and “The Papers” in this chapter suggests that the interview may be a problem whose implications reach well beyond the limited interaction with the journalist to all conversation involving the selective disclosure of information with an unseen audience in mind.
Conclusion
Authors: Rubery Matthew
Published: September 2009

The book's conclusion restates the ways in which the shape taken by the Victorian novel must be understood alongside the simultaneous development of the news as a commercial commodity read by up to a million readers per day. It has been the aim of this book to dismantle any such conceptions of the novel and the newspaper as inhabiting separate spheres. Instead, the novelty of newspapers was evident in the newness and literariness of a form of narrative that has shaped the way we read literature since its conception in the 19th century.
Getting Health Reform Right
Authors: Roberts Marc , Hsiao William , Berman Peter , Reich Michael
Published: September 2009

This book provides a framework for developing and analyzing health sector reforms, based on international experience. It offers practical guidance and stresses the need to take account of each country's economic, administrative, and political circumstances. The book explains how to design effective government interventions in five areas—financing, payment, organization, regulation, and behavior—to improve the performance and equity of health systems around the world. There are a number of critical features in the book's approach to health-sector reform. The first is to see the health sector as a means to an end. Reformers should judge their systems by the consequences, to define problems in terms of performance deficiencies, and to assess proposed solutions by whether they promise to remedy those deficiencies. This approach leads to an analytically rigorous method for problem definition, causal diagnosis, and policy development. This kind of method has often been lacking in health reforms efforts, and its lack is partially responsible for the disappointing results. A second major feature of the book's approach is a commitment to combining international experience with deep sensitivity to local circumstances. A third feature of this study is that the book puts forward a multidisciplinary approach to the problems of health-sector reform. Finally, the book argues that health-sector policy inevitably involves ethical choices.
The Health-Reform Cycle
Authors: Roberts Marc J. , Hsiao William , Berman Peter , Reich Michael R.
Published: September 2009

This chapter provides an introduction to the policy cycle for health-sector reform. It discusses the six stages of the process: problem definition, diagnosis, policy development, political decision, implementation, and evaluation.
From Diagnosis to Health-Sector Reform
Authors: Roberts Marc J. , Hsiao William , Berman Peter , Reich Michael R.
Published: September 2009

Once health-sector reformers have decided which performance problems to focus on—that is, once they have decided on their strategic priorities—they have to go on to the next stages of the policy cycle. This means, first of all, figuring out the causes of the poor performance they are concerned with—a process called “diagnosis.” Then they have to decide what to do about the situation—the process called “policy development.” This chapter discusses those activities and offers advice about how to carry them out, so as to produce more effective health-sector reform.
Regulation
Authors: Roberts Marc J. , Hsiao William , Berman Peter , Reich Michael R.
Published: September 2009

This chapter discusses “regulation”, which refers to the use of the coercive power of the state to change the behavior of individuals and organizations in the health sector. The chapter is organized around five issues: What is regulation and why regulate? How do regulations influence the performance of health systems? What are the major determinants of regulatory success? What are the major types of regulation in the health sector? It offers some conditional guidance about how to use regulation effectively.
Behavior
Authors: Roberts Marc J. , Hsiao William , Berman Peter , Reich Michael R.
Published: September 2009

This chapter describes methods for changing individual behavior through population-based interventions. The main concern is how behavior can be used to improve health-system performance and promote public-health goals. The chapter begins by introducing the basic concepts of behavior change in relation to health-system performance. It then explores four categories of individual behavior that are important to that performance. It presents advice about how to achieve behavior change, through a discussion of the basic elements of social marketing. It concludes with a discussion of the strengths and weaknesses of different behavior-change strategies in the context of health-sector reform.
Conclusions
Authors: Roberts Marc J. , Hsiao William , Berman Peter , Reich Michael R.
Published: September 2009

The analysis presented in this book depends on a series of critical propositions about the structure and functioning of health-care systems and about the health sector reform processes. This concluding chapter presents these propositions and discusses their implications for the reform process. It then reviews some of the substantive lessons from Part II on the control knobs for health sector reform.
Two The Origins of the Ninth Amendment
Authors: Kurt T Lash
Published: September 2009

This chapter begins by presenting the most commonly told story about the historical Ninth Amendment. It argues that the Ninth Amendment did not emerge unsought out of the unique mind of James Madison. Like the rest of the Bill of Rights, the origins of the Ninth Amendment are found in concerns raised by the ratifiers in the state conventions. The chapter turns to the drafting of the Ninth Amendment and considers terms that the founding generation likely viewed rather differently from the way we understand them today. It concludes with a discussion of the dual nature of retained rights.
Seven The Ninth Amendment and the Marshall Court
Authors: Kurt T Lash
Published: September 2009

This chapter continues the discussion of the history of the Ninth Amendment and eventually takes it to the one place where no history of it can be found—the judicial opinions of Chief Justice John Marshall. It is argued that different people used the Ninth Amendment in different ways. Some read the amendment as significantly restricting federal power; others insisted that the amendment placed few if any constraints on federal power. But these are differences of degree, not kind. Every court and commentator who took a position on the Ninth Amendment in the initial decades of the Constitution—whether Federalist or Anti-Federalist or Democratic-Republican, nationalist or states' rightist, drafter or ratifier—all described the Ninth as echoing the same federalist principles as the Tenth. Rather than considering the original meaning of the Ninth Amendment, the chapter focuses on what happened to the original meaning of the Ninth Amendment.
Nine The Fall of the Original Ninth Amendment and the Rise of New Deal Constitutionalism
Authors: Kurt T Lash
Published: September 2009

This chapter begins with a fairly exhaustive account of the use of the Ninth Amendment in state and federal courts prior to the New Deal. There is nothing new here in terms of theory: one finds the same analysis of the Ninth Amendment already developed in prior chapters repeated over and over again in state and federal courts throughout the Progressive era. There is a purpose, however, to including this history. One of the most durable myths about the Ninth Amendment is that it attracted little attention prior to the modern Supreme Court's discovery of the Ninth in Griswold v. Connecticut. The present discussion puts this myth permanently to rest. The second half of the chapter helps explain how the myth arose in the first place.
Ten Death and Transfiguration: How the Ninth Amendment Got Filed in the Wrong Place
Authors: Kurt T Lash
Published: September 2009

This chapter discusses how the transfigured Ninth Amendment, although used in support of a broad conception of individual freedom, has become a far smaller provision than that envisioned by its framers and has been rendered altogether unenforceable as an independent provision in the Bill of Rights. It describes how the Ninth Amendment has played an important role in matters involving the Supreme Court of the United States.
Diagnosis and Management of Asthma in the Medical Marketplace of India: Implications for Efforts to Improve Global Respiratory Health
Authors: Van Sickle David
Published: September 2009

The increasing burden of asthma in developing countries has emerged as an important challenge to global public health. While international organizations have emphasized the role of guidelines in improving the diagnosis and management of asthma, very little is known about how practicing clinicians in these settings have responded to the rising prevalence and growing public health importance of these diseases. This chapter presents a case study from India that examines the changing social and epidemiological profile of asthma, and the evolution of allopathic clinical practices in the context of a pluralistic medical marketplace. Through ethnographic research among physicians, it identifies day-to-day determinants of diagnosis and treatment of patients in a variety of clinics, and examines the factors limiting their implementation of asthma guidelines.
Situating Stress: Lessons from Lay Discourses on Diabetes
Authors: Schoenberg Nancy E. , Drew Elaine M. , Stoller Eleanor Palo , Kart Cary S.
Published: September 2009

Researchers increasingly are examining physical and psychological pathways that affect and are affected by diabetes, including stress. While biomedical researchers and practitioners are beginning to recognize the association between stress and diabetes onset and management, laypersons have long-standing and extensive insights into the multiple ways in which stress is associated with the diabetes disease process. This chapter examines lay perspectives on stress and diabetes among a multiethnic sample of eighty adults. Participants suggest varying arenas in which stress intersects with diabetes, including stress as implicated in the origin of diabetes, as a threat to maintaining glycemic control, as a challenge to self-management, and as a precursor to and a consequence of diabetes complications.
Understanding Pregnancy in a Population of Inner-City Women in New Orleans—Results of Qualitative Research
Authors: Kendall Carl , Afable-Munsuz Aimee , Speizer Ilene , Avery Alexis , Schmidt Norine , Santelli John
Published: September 2009

Unintended pregnancy is defined as a pregnancy that is mistimed or unwanted, and this classification has been widely used in survey research. This chapter explores the utility of these constructs for women in New Orleans, LA. It examines sexual debut and history, contraceptive knowledge and use, abortion, pregnancy history, partner relations, and service use among seventy-seven women (seventy-three of whom were African-American) using a qualitative methodology. It provides insight into the cultural and social context in which these events and decisions take place, and explores the multiple dimensions that shape women's sexual behaviors and their desires for pregnancy. Many structural and individual factors affect women's preferences and ability to postpone a pregnancy or to use contraception.
The Limits of “Heterosexual AIDS”: Ethnographic Research on Tourism and Male Sexual Labor in the Dominican Republic
Authors: Padilla Mark B.
Published: September 2009

For nearly two decades, the AIDS epidemic in the Caribbean—now showing HIV prevalence rates that are second only to Sub-Saharan Africa—has been officially described in public health and epidemiological reports as “heterosexual.” At the same time, men with a history of same-sex exchanges or who are involved in sexual commerce have been largely neglected or under-prioritized in HIV/AIDS policies and programs, despite persistently high HIV infection rates in this population. This chapter draws on three years of ethnographic research in two cities in the Dominican Republic among men involved in informal sexual exchanges in tourism areas, and considers how men's experiences with tourists problematizes static public health labels such as “the heterosexual epidemic.” It is argued that traditional public health approaches are largely incapable of capturing the nuances of men's experiences or the ways their behavior is shaped by the large-scale transformations in gender, sexuality, and work.
Anthropological Contributions to the Development of Culturally Appropriate Tobacco Cessation Programs: A Global Health Priority
Authors: Nichter Mark , Nichter Mimi , Padmawti Siwi , Thresia C.U. ,   Project Quit Tobacco International Group
Published: September 2009

This chapter describes Project QTI, a pioneering attempt to find out what we need to know to successfully carry out tobacco cessation in clinical and community settings. Formative research carried out in India and Indonesia is described. Both countries have high prevalence rates of tobacco use across all social classes, popular indigenous as well as imported tobacco products, few cessation activities, and no established tobacco curriculum in medical schools. A biopolitical model is presented for encouraging systematic assessment of tobacco dependency at the sites of the body, environment, and state. The tobacco control field recognizes the value of transdisciplinary research. The chapter describes Project QTI's ongoing attempts to build a community of tobacco cessation practice that spans both efforts to encourage individuals to quit tobacco use and communities to establish smoke free households and worksites.
From Street Research to Public Health Intervention: The Hartford Drug Monitoring Project
Authors: Singer Merrill , Mirhej Greg , Santelices Claudia , Saleheen Hassan
Published: September 2009

This chapter reports on the purpose, methods, and findings of a CDC-funded project in Hartford, Connecticut, entitled the Community Responses to Risks of Emergent Drug Use Project. This project was designed to (1) use ethnographic and epidemiological data collection to identify and track emergent drug use trends; (2) analyze these patterns in terms of the sociodemographic traits of participants; (3) assess the potential impact of identified changes on local public health; and (4) use a Participatory Action Research (PAR) model to implement community-based public health responses to research findings in collaboration with a community advisory group. Three illicit drug use trends examined in the project—the spread of methamphetamine among hard-core drug users, the adoption of PCP among emergent adult users, and the use of sweetened cigars among youth—are assessed while describing applied initiatives designed to address the public health implications of identified drug use trends.
Sexual Risk Reduction among Married Women and Men in Urban India: An Anthropological Intervention
Authors: Schensul Stephen L. , Verma Ravi K. , Nastasi Bonnie K. , Saggurti Niranjan , Mekki-Berrada Abdelwahed
Published: September 2009

This chapter describes research, intervention, and evaluation projects conducted over a decade by a collaborative Indo-US group that are focused on the prevention of HIV/STI among married women and men living in urban poor communities in Mumbai, India. Formative research on men's and women's sexual and reproductive health, using qualitative and quantitative methodologies, identified syndromes that provided the opportunities for linking HIV/STI prevention intervention with highly salient culturally-based beliefs. This research also led to the design of multilevel intervention at the community, provider, and patient level that utilizes an ecological model consistent with principles drawn from Indian systems of medicine. The intervention and its results form the basis for a set of guidelines concerning the role of anthropology in public health interventions.
Making Pregnancy Safer for Women around the World: The Example of Safe Motherhood and Maternal Death in Guatemala
Authors: Berry Nicole S.
Published: September 2009

Maternal mortality has become one of the most important topics in global health, as evidenced by its inclusion in the eight Millennium Development Goals designated by the United Nations. This chapter uses examples from ethnographic fieldwork with Kaqchikel Maya in Sololá, Guatemala, to explore reasons why lowering maternal mortality has been so challenging. It explores how understandings of pregnancy-related problems in areas where maternal mortality is high can be antithetical to those assumed by global health policies. In doing so, it provides an important example of how to reframe understandings of why women die, which, hopefully, can lead to new ways of addressing the problem.
Counting on Mother’s Love: The Global Politics of Prevention of Mother-to-Child Transmission of HIV in Eastern Africa
Authors: Moland Karen Marie , Blystad Astrid
Published: September 2009

In areas where breastfeeding is normative and essential to infant survival, prevention of mother-to-child transmission of HIV (PMTCT) represents a public health dilemma. This chapter discusses the problem of adherence to infant feeding recommendations in PMTCT programmes in Ethiopia and Tanzania. It demonstrates how a set of discourses on prevention, rights, and choice places the responsibility for child survival on the mother while at the same time conceptualizing her body, and particularly her milk, as an impediment to that survival. Focusing on HIV positive mothers' breastfeeding experiences, it argues that although “mother's love” is located at its core, the PMTCT program challenges culturally anchored ideas about decision-making and authority, gender and motherhood and hence struggles with local relevance and support.
The Brazilian Response to AIDS and the Pharmaceuticalization of Global Health
Authors: Biehl João
Published: September 2009

This chapter examines the Brazilian response to AIDS, revealing the possibilities as well as the inequalities that accompany a magic-bullet approach to health care. It moves between a social analysis of the institutional practices shaping this therapeutic policy and an account of the experiences of people affected by it, particularly in impoverished urban settings where the epidemic is spreading most rapidly. It draws from interviews carried out with activists, policymakers, health professionals, and corporate actors and from longitudinal study of grassroots care services. A pharmaceutically-centered model of public health has crystallized and a multitude of networks and variations in AIDS care have emerged on-the-ground. Marginalized AIDS patients are often stigmatized as noncompliant or untreatable, becoming invisible to the public.