OBJECTIVE: We examined the direct and indirect means by which patients express a desire for analgesic medication. METHODS: Back pain patients presenting to an academic ED were invited to participate in a study of patient-provider communication. Audio-recorded encounters were transcribed verbatim and transcripts analyzed using a qualitative approach based on conversation analysis. RESULTS: Requests for … Read more

Today, nearly every US baby is screened for more than fifty rare genetic disorders, regardless of insurance status or ability to pay. This article explores the dramatic expansion of state-mandated newborn screening by analyzing affective enactments within public discourses of newborn screening advocacy. Drawing on public records from newborn screening policy hearings and secondarily on … Read more

OBJECTIVES: To assess the relationship between older adults’ perceptions of shared decision-making in the selection of an analgesic to take at home for acute musculoskeletal pain and (1) patient satisfaction with the analgesic and (2) changes in pain scores at 1 week. DESIGN: Cross-sectional study. SETTING: Single academic emergency department. PARTICIPANTS: Individuals aged 65 and … Read more

It has been close to six decades since Watson and Crick discovered the structure of DNA and more than ten years since the human genome was decoded. Today, through the collection and analysis of a small blood sample, every baby born in the United States is screened for more than fifty genetic disorders. Though the … Read more

Positive newborn screening (NBS) results cause significant parental distress, but little is known about how parents find out about children’s screening results and what they are told. This qualitative, exploratory study reports on parents’ perceptions of the initial communication of NBS results. Participants included the parents of 75 infants referred to a metabolic clinic in … Read more

In the U.S. multidisciplinary pediatric pain clinic where I conducted 18 months of fieldwork, a widely held explanatory model tied the neurobiology of intractable pain to certain features of pervasive developmental disorders (PDD) such as concrete thinking, an interest in details, and hyper-attentiveness. Clinicians used terms such as “sticky brains” and “sticky neurons” to describe … Read more

In a significant departure from established criteria for population screening, a 2006 report by the American College of Medical Geneticists (ACMG) argued that newborn screening may be justified by family and societal benefits even if the screened infant does not stand to benefit. The ACMG report has since been the backdrop for considerable debate about … Read more

What are the social consequences of the recent expansion of newborn screening in the United States? The adoption of new screening technologies has generated diagnostic uncertainty about the nature of screening targets, making it unclear not only whether a newborn will develop a disease but also what the condition actually is. Based on observations in … Read more