Subtle Messages Research Articles

TU-C-203-02: Negotiation Challenges for Medical Physicists

Medical Physicist face, and often create for themselves, unique challenges in working out contracts for the provision of professional services. We are very often in the position of trying to sell something at a very high cost to someone who does not know or care what we do. The inclination is strong on both sides to not get bogged down in the details. Negotiation often tumbles to a simple matter of, “I'll take that job for this amount of money.” Only later does it unfold that the two parties each had very different ideas of “normal expectations.” While this cannot be completely avoided, especially in the context of rapid hospital administrator turnover, there are things that can be done to lengthen the Half‐life of Despair. Clear specifications of the scope of duties, areas of responsibility and authority, work environment and schedule, etc. should always be central to the process of agreeing to do work for pay. We must bear in mind that these things are necessary but not sufficient. Contracts exist as a useful tool for future recollection of the conversations that generate them, but ultimately the only parties that benefit from the existence of a contract in a situation gone bad are the attorneys who are engaged to parse it. A contract will not save you from a sinking ship. Whether the contract is ever useful or not, contract negotiation is vitally important as a process. Contract negotiation is the moment in a relationship when one has the clearest opportunity to establish the tone of the relationship and to sample the culture of the organization. The negotiation period is the last time that everything will be possible. To be successful in that process a Medical Physicist is best served by having a very clear understanding of his/her own professional identity and a heightened awareness of the subtle messages that are sent from the other side. These are skills that many of us could stand to refine for ourselves. In this brief presentation I will touch on some of the elements of a successful negotiation of acceptable terms to perform the professional work of a Medical Physicist, going beyond the well‐known boilerplate elements of a professional contract to the more subtle and much more important challenge of framing the infrastructure of a sustainable relationship with strangers in a very short time. Learning objectives: 1. Understand the difference between “taking a job” and “joining a practice.” 2. Explore how professional identity influences the negotiation process. 3. Be reminded that work relationships are about working with people much more than about well‐crafted contracts. 4. Understand the importance of a well‐crafted contract.

The effect of cartoon movies on children's gender development

Cartoon movies which are necessary sources of fun for children also have educational aspects. Innocent display of cartoons which give many subtle messages include various negativities. One of these negativities is related with the characters’ gender. Characters in cartoon movies include females, males, animals and inanimate objects. While male and female characters’ roles are shaped according to existing stereotypical role models in society, animal and inanimate characters have anthropomorphic characteristics like walking on two feet or speaking. Such characters have their places in these movies with their human-like characteristics. Animal and inanimate characters are sometimes designed on the bases of stereotypical female and male role models and sometimes these characters are seen as asexual or homosexual. In some cartoon movies, transformations between sexes draw attention. For example, a character designed as female can be transformed into male via a magical process. Such changes of sex, asexuality and representation of characters according to the stereotypical role models are alarming. The fact that children spend much of their time watching television and especially choose such movies augments these concerns. Children coming across with such complicated gender role models will affect them negatively in the future years of their lives.This study, “The Effect of Cartoon Movies on Children's Gender Development”, will analyze these cartoons in which complicated gender role models are presented critically and propose some solutions to this problem.

Learning to See Inequity in Science

Learning to See Inequity in Science

Subtle Messages in Clinical Supervision

The supervision literature is replete with cautions that supervision practice often must be subtle and nuanced to meet the individualized needs of supervisees. It offers little direction, however, for how and why a supervisor might choose a more subtle, indirect approach over a more direct approach. Some guidelines for making this decision and some examples of more subtle, indirect approaches are described and illustrated.

An Unfortunate and Avoidable Component of American Pharmacy: Tobacco

An Unfortunate and Avoidable Component of American Pharmacy: Tobacco

Hypertension guidelines: thresholds, targets, and teratogenicity

The current British Hypertension Society (BHS) Guidelines for the management of Hypertension run to an impressive 46 pages.1 The Quick Reference Guide on management of hypertension in adults in primary care published by the National Institute of Health and Clinical Excellence (NICE) in June 2006 is shorter at 11 pages.2 Both documents give essentially the same message about thresholds, treatments, and targets for hypertensive patients with the NICE guide providing easy to follow, colourful flow diagrams. By definition clinical guidelines need to be clear and user-friendly but I worry that important and subtle messages may be lost completely in the process. A case in point is the management of hypertension in young women of childbearing age. In the NICE Quick Reference Guide only one line mentions this group saying that beta blockers should be avoided in women of childbearing age. There is no mention of why and no reference to the potential dangers of angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) should these women become pregnant. Research emerging in the early 1990s indicated a causative association between the use of ACE inhibitors during pregnancy and the development of severe fetal abnormalities. A significantly increased incidence of oligohydramnios, neonatal renal failure, pulmonary hypoplasia, calvarial hypoplasia, and fetal death were reported. These effects are thought to be the result of hypoperfusion of the fetal kidneys during development.3 The increased risk of fetal abnormalities was initially thought to be limited to women receiving ACE inhibitor therapy in the second and third trimesters of pregnancy. However, a more recent study has suggested a significantly increased risk (>2.7) of major congenital malformations in women receiving ACE inhibitor therapy in the first trimester of pregnancy.4 A higher incidence of fetal abnormalities in the offspring of women taking ARBs during pregnancy has also been noted.5 Current BHS guidelines recommend ACE inhibitors as first-line agents for younger, non-black patients but advise that these agents should be avoided in women who wish to become pregnant. The recommendations also state that ACE inhibitors and ARBs should be discontinued immediately if a woman were to become pregnant while receiving treatment with either agent. The Quick Reference NICE guidelines suggest beta blockers may have a role in younger women but do not specify why.2 Despite their known adverse effects, recent US data shows that 4.4% of women of childbearing age (15–44 years) take ACE inhibitors, reflecting an 83% increase in use from 1995–2002.6 In addition, a UK poll suggests that 40% of pregnancies are unplanned, with over half of these due to lack of contraception.7 At the Hypertension Clinic, University Hospital Birmingham we recently investigated the number of women of childbearing age (16–45 years), who had been prescribed ACE inhibitors or ARBs in primary care before referral.8 In addition, contraceptive use by these women was evaluated to assess whether adequate precautions were being taken to prevent pregnancy in these at-risk patients. A cohort of female patients aged 16–45 years was identified from approximately 1500 new referrals from January 2004 to October 2006, excluding those not taking antihypertensive medication. Contraceptive status was established where possible. Forty-seven of 101 (47%) women aged 16–45 years were taking an ACE inhibitor (n = 35) an ARB (n = 11) or both (n = 1) of whom 26 (55%) were aged 16–40 years. In this younger group, eight were using no contraception and three were using barrier methods only. In other words, one-quarter of women in the study were taking these agents and were aged 40 years or less; of these, many were not using reliable contraception. The study identifies a worrying trend to use ACE inhibitors or ARBs in younger women who are at risk of poor perinatal outcomes if they become pregnant. On the basis of this small study and my own clinical experience I feel that the BHS and NICE guidelines may put younger women at risk if doctors are unaware of potential fetotoxic and teratogenic consequences of prescribing ACE inhibitors and ARBs. When I give talks to GPs and hospital doctors, several colleagues confirm that they were previously unaware of such an association. A final point that the study highlighted was the surprising number of young women who were taking antihypertensives in the first place. This brings me on to thresholds for intervention, white coat hypertension, and appropriateness of treatment in this very low-risk group: important subjects for another Viewpoint, perhaps.

OLHARES SOBRE O DESEJO SEXUAL

A comunicação e o simbolismo transformaram o significado do impulso sexual nos humanos. A comunicação emocional e a linguagem simbólica, associadas às capacidades intelectuais e sociais, produzem uma alteração qualitativa, transformando o coito em relação. A sexualidade passa a poder ser ensinada, regulamentada, reprimida ou supervalorizada, possuindo fortes condicionantes sociais e encontrando-se inter relacionada, às diversas experiências emocionais do desenvolvimento de cada um. O desejo sofre interferências múltiplas, advindas desde o período fetal, equilíbrio neuro- endócrino, interações familiares, vínculos afetivo-sexuais, normas morais e religiosas, os interditos sociais, as interações pessoais, a atração, o apaixona- mento, o equilíbrio hormonal, o "outro", enfim, à saúde física, psíquica e social. Fatores que caracterizam e diferenciam o comportamento e o desejo sexual de cada um. Segundo Masters e Johnson (1997), não importa o quanto seja interessante tentar descrever um modelo prático dos vários componentes do desejo sexual, o que falta sempre é a sutileza que distingue a luxúria ou a paixão, das outras variedades de desejo sexual. O erotismo é um processo multifacetado, através do qual, nossa capacidade inata para a "tesão" foi moldada, suprimida ou supervalorizada. A moldagem erótica, ou a forma como se constituirão os conteúdos desejados, se fará através de mensagens claras ou sutis, conscientes ou inconscientes, conectadas às vivências afetivo- sexuais de cada um. O resultado de tudo isso irá esculpir a forma, a intensidade, os objetos e as possibilidades de manifestação do desejo (latente, fantasiado, expresso ou executado).

Goodies and Baddies: The Presentation of German Police and Criminals in East and West Television Drama

Criminal Justice is never only about identifying and sentencing unwanted and thus, outlawed behaviour. As one of the closest contacts between state and citizens, Criminal Justice implies also a system of values and more or less subtle messages which the state wants to transmit to the people. In all modern legal systems, Criminal Law is about society as a whole being deterred from crime, educated and moreover ensured of the state's power, its efficiency and above all its benevolence. In other words, Criminal Justice does not only deal with offenders and victims but additionally with its own presentation in public and the citizens’ perception of it.

Home Bound: Growing Up with a Disability in America, and: Women with Disabilities Aging Well, and: (Dis)embodied Form (review)

Reviewed by: Home Bound: Growing Up with a Disability in America, and: Women with Disabilities Aging Well, and: (Dis)embodied Form Martina Robinson (bio) Home Bound: Growing Up with a Disability in America by Cass Irvin. Philadelphia: Temple University Press, 2003, 223 pp., $59.50 hardcover, $19.95 paper. Women with Disabilities Aging Well by Patricia Noonan Walsh and Barbara LeRoy. Baltimore: Paul H. Brookes Publishing, 2004, 166 pp., $29.95 paper. (Dis)embodied Form by Anita Ghai. New Delhi: Her-Anand Publications, 2003, 180 pp., $15.00 paper. Historically, disabled women have been largely absent from activist and academic discourses within disability studies (which is mostly male-centered) and feminist theory (which is mostly focused on able-bodied people), as well as from revolutionary circles in general. We have been spoken about and talked at but were seldom a part of the conversation. In the late 1980s, however, a small band of authors, academics, and artists began to give a voice to our special and particular concerns, experiences, and strengths. Today, even though we are still often overlooked, dismissed, and pitied by both our fellow feminists and our brothers with disabilities, disabled women are no longer mute in either arena. The three books and four authors I am reviewing each seek to add volume to disabled women's collective demand to be heard. Home Bound: Growing Up with a Disability in America is an autobiographical memoir recounting the trials, tribulations, and eventual "radicalization" of the author Cass Irvin. The book's five chapters are in loose chronological order, featuring several flashbacks. In the first chapter, readers learn about Irvin's family history and station, as well her own quiet, isolated, slightly abusive, somewhat privileged experience as a child with polio in the South during the 1950s and early 1960s. Irvin speaks eloquently about the subtle and not so subtle messages that disabled children receive regarding personal care provision, as well as providing insight into the education of disabled children before the passage of the Individuals with Disabilities Education Act (IDEA), which mandated free and appropriate public education for all disabled students. When I was ten years old, my sister, Ann, told me that the reason Mom drank so much was because she had to take care of me. . . . My aunts complimented me on the fact that I never complained, never felt sorry for myself; I was praised for having adjusted to my handicap. And so I learned that people like you better when you make few demands on them. Finally, in my senior year I got to go to school all day (actually four hours a day, because that's all the credits I needed). (5-6) As they move forward through her narrative, readers discover the complexities, incongruities, and circularity of her existence. We notice the double-edged sword of her relationship with the Warm Springs Rehabilitation Center, which both freed and isolated her at once. As she grows into adulthood, readers will find their own lives reflected in her struggles for independence, acceptance, and love. No radical tale of the 1960s could be told without exploring the contributions of the civil rights movement and the struggle for women's liberation. While Irvin rightly critiques these movements for their lack of access, she is careful to acknowledge their importance in her own political coming of age. While narrative on sexual orientation is lacking, readers cannot miss the connections she draws between ableism, sexism, and racism. I would recommend this book for introductory classes in Women Studies or disability studies. It would also be a unique addition to the reading list for a course in memoir, whether feminist or not. Because it reads like a novel, I would also suggest it for courses taken by students just transitioning from high school to college. Women with Disabilities Aging Well by Patricia Noonan Walsh and Barbara LeRoy reports on an exciting cross-continent project that gathered the personal narratives of 167 women with intellectual disabilities and used them to inform policy recommendations in regards to services for that population. Women from eighteen countries, ranging in age from 40 to 71 and up, were interviewed about subjects ranging from economic independence to...

ABSTRACT

This monograph provides the first in-depth look at how mothers and young children talk about gender, to discover the potential role of language in fostering gender stereotypes. Mothers and their sons/daughters, who were 2- ,4- , or 6- years of age, were videotaped discussing a picture book that focused on gender. A consistent contrast was found between mothers' explicit endorsement of gender stereotypes and implicit emphasis on gender. Although mothers rarely expressed gender stereotypes directly, they emphasized gender concepts indirectly, by referring to gender categories, providing gender labels, contrasting males and females, and giving approval to their children's stereotyped statements. With increasing age, children were more focused on gender categories and stereotypes, but also more gender-egalitarian. Gender-egalitarian items (e.g., a female fire-fighter) were associated with less overt stereotyping, but also with more implicit talk about gender. Altogether, mothers' language input conveys a wealth of subtle messages about gender from which children may construct their own beliefs.

Media interventions to promote responsible sexual behavior

While the media have been used effectively to promote sexual responsibility in other countries for decades, few such opportunities have been seized in the United States. Mass media may be especially useful for teaching young people about reproductive health because elements of popular culture can be used to articulate messages in young people's terms, in language that won't embarrass them and may even make safe sex more attractive. Media can potentially change the way people think about sex, amidst cultural pressures to have sex at a young age, to have sex forcefully, or to have sex unsafely. Information can be communicated through a variety of channels—small media (e.g., pamphlets, brochures, and the Internet) and mass media—and in a variety of formats—campaigns, news coverage, and educational messages inserted into regular entertainment programming. Several international studies show that exposure to family planning messages through television, radio, and print media are strongly associated with contraceptive use. Domestically, safe sex media campaigns have been associated with increased teen condom use with casual partners, and reductions in the numbers of teenagers reporting sexual activity. Due to private ownership and First Amendment concerns, U.S. sexual health advocates have been working with the commercial media to incorporate subtle health messages into existing entertainment programming.

Are We Seeing Things?

The research on African Americans and television advertising is abundant with empirical evidence that attests that Blacks have come a long way as far as inclusion is concerned. Numerous studies cite the increase in Black presence (Bowen & Schmid, 1997; Bristor, Lee, & Hunt, 1995; Licata & Biswas, 1993; Zinkhan, Qualls, & Biswas, 1990). Nevertheless, one does not have to depend on scholarly research to verify the increase in Black presence in television commercials. It becomes obvious as one watches television. What may not be readily evident to the average television viewer are the underlying or subtle stereotypical messages that emanate from some of the television commercials that feature Black people, particularly the Black female. Advertising industry decision makers should be commended for the increase in the inclusion of Blacks in television commercials. They should, however, become sensitized to the social importance of being concerned about how African Americans are depicted in the commercials they produce.

Enhancing Gifts and Talents of Women and Girls

This article presents an overview of some relevant historical/societal influences on how expectations (e.g. overt and more subtle messages conveyed through the media) of women and girls influence realization of their full potential, often negatively affecting achievement and career choice (Wilgosh, 1993, 1996a, 1996b). The research framework is then extended to a further examination of contemporary media influences on women and girls, including development and application of a tri-dimensional categorization system for examining how informational messages impact on young women and girls. The proposed categorization system aims at assisting educators and counsellors in undoing influences, which might reinforce underachievement. To facilitate movement from potential to performance, consideration will also be given to developing innovative educational strategies and approaches to encourage expression of gifts and talents and maximize achievement of adolescent girls and young women.

Enhancing Gifts and Talents of Women and Girls

This article presents an overview of some relevant historical/societal influences on how expectations (e.g. overt and more subtle messages conveyed through the media) of women and girls influence realization of their full potential, often negatively affecting achievement and career choice (Wilgosh, 1993, 1996a, 1996b). The research framework is then extended to a further examination of contemporary media influences on women and girls, including development and application of a tri-dimensional categorization system for examining how informational messages impact on young women and girls. The proposed categorization system aims at assisting educators and counsellors in undoing influences, which might reinforce underachievement. To facilitate movement from potential to performance, consideration will also be given to developing innovative educational strategies and approaches to encourage expression of gifts and talents and maximize achievement of adolescent girls and young women.

Going to College: How Social, Economic, and Educational Factors Influence the Decisions Students Make

Going to College tells the powerful story of how high school students make choices about postsecondary education. Drawing on their unprecedented nine-year study of high school students, the authors explore how students and their parents negotiate these important decisions. Family background, finances, education, information-all influence students' plans after high school and the career paths they pursue, as do the more subtle messages delivered by parents and counselors which shape adolescents' self-expectations. For high school guidance counselors, college admissions counselors, parents and teachers, and public policy makers, this book is a valuable resource that explains the decision-making process and helps adults to help students make appropriate choices. The authors identify predisposition, search, and choice as the three stages in the student decision-making process. Predisposition refers to the plans students develop for education or work after they graduate from high school. The search stage involves students discovering and evaluating a variety of colleges and universities. In the choice stage, students choose a school to attend from among a list of institutions that are being seriously considered. Understanding exactly how students move through the predisposition, search, and choice stages of the college decision-making process can help students and parents prepare themselves for this process and consider a wider array of options. For education professionals, understanding this process can lead to new initiatives to guide students and families effectively-by providing better incentives for college savings, for example, or devising more effective early information programs about postsecondary education. Going to Collegeis the first book to seriously study over an extended period the decisions that have a pervasive and lasting impact on individual careers, livelihoods, and lifestyles. The authors conclude with important recommendations for improving academic support, exploring various financial options, providing early encouragement-in other words, for recognizing the factors that influence students' decisions, and knowing when to pay attention to them.

Packaged Sentiments

This paper analyzes the social uses and meanings of greeting cards. It argues that cards occupy an intermediate and shifting place in between the opposing social categories of ‘gift’ vs. ‘commodity’. The fact that the card is not a pure gift is the source of social criticisms of cards as impersonal. But the card’s ambiguous status is also at the heart of its unique communicative potential. Analysis of specific cards and card categories shows how card senders can exploit various and multiple dimensions of the card’s gift and commodity-like qualities to express socially authenticated identities and sentiments, as well as to send subtle and complex new messages about identities and relationships. Card use also shows how commodities can be ‘appropriated’ as gifts in the act of shopping and choosing; moreover, the consumption of cards is depicted as a dynamic site of ‘virtual’ interactions between sender and receiver. The specific case of greeting cards is used to illustrate the more general point that most things are not intrinsically ‘gifts’ or ‘commodities’. Rather, things acquire these identities by virtue of social interactions and processes.

Counselling to enhance gifts and talents and undo underachievement of girls

Earlier papers (Wilgosh, 1993, 1996b) examined how societal expectations of girls influence their failure to realize their full potential, particularly in mathematics and sciences. Societal influences on girls, particularly overt and more subtle messages conveyed through the press, were examined. This paper reviews issues and concerns identified in the earlier papers. Then, counselling approaches are considered, to enhance gifts and talents and undo underachievement which may be, at least in part, a result of negative and confusing messages girls receive through many different societal sources.

Revisiting Tobin's 1950 study of food expenditure

This re-analysis of Tobin's (1950) study makes three points: 1. Graphs are a powerful device for discovery and for communication, and can reveal much of the information in the data. 2. Squeezing out the more subtle multivariate messages requires some solution to the usual overparameterization problem. Data-mining is still the treatment of choice for this crippling disease, but it is more akin to leeches than to anti-biotics. A Bayesian sensitivity analysis is an alternative, but it isn't a perfect cure either. 3. Clear identification of the issues can help keep the enterprise from wandering off in technically amusing but largely irrelevant directions. © 1997 John Wiley & Sons, Ltd.

Multi-level structure of meaning in a business law tutorial

This paper investigates the tutor’s discourse in a university classroom for a business law tutorial. It is argued that the discourse is structured on several levels. On a deeper level, linguistic models of values underpinning the legal system can be discerned. Sinclair and Coulthard’s classroom taxonomy was applied firstly to the discourse, followed by further investigation of the moves in the exchanges along the lines of Halliday’s interpersonal, ideational and metalanguage components. In addition, characteristics of legal language were explored. It was found that, in combination, these form the medium through which the linguistic models of the legal system are presented. It is suggested that these elements of the discourse play an important role in initiating the students into the subject’s discourse community. It is further suggested that students with less facility and flexibility in English may be positioned less advantageously to benefit from these subtle messages.

Health care personnel's critique on the Philippines' first movie on AIDS.

The "Dolzura Cortez Story" was the Philippines' first movie on AIDS that provided 'a name and a face' among the 50 recorded lives that were lost to AIDS in 1992. This movie was utilized as a focus of discussion by some health care personnel to express their thoughts, opinions and recommendations regarding the use of cinema as a powerful tool for AIDS information dissemination.