Melissa Osborne

Hepatitis C virus (HCV) infection is a major source of morbidity and mortality in the United States. HCV is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood, most commonly through injection drug use. No vaccine against hepatitis C exists and no effective pre- or postexposure prophylaxis is available. More than half of persons who become infected with HCV will develop chronic infection. Direct-acting antiviral treatment can result in a virologic cure in most persons with 8-12 weeks of all-oral medication regimens. This report augments (i.e., updates and summarizes) previously published recommendations from CDC regarding testing for HCV infection in the United States (Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR Recomm Rec 2012;61[No. RR-4]). CDC is augmenting previous guidance with two new recommendations: 1) hepatitis C screening at least once in a lifetime for all adults aged ≥18 years, except in settings where the prevalence of HCV infection is <0.1% and 2) hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is <0.1%. The recommendation for HCV testing that remains unchanged is regardless of age or setting prevalence, all persons with risk factors should be tested for hepatitis C, with periodic testing while risk factors persist. Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks.

BACKGROUND: Prior research has shown a gender gap in the evaluations of emergency medicine (EM) residents' competency on the Accreditation Council for Graduate Medical Education (ACGME) milestones, yet the practical implications of this are not fully understood. OBJECTIVE: To better understand the gender gap in evaluations, we examined qualitative differences in the feedback that male and female residents received from attending physicians. METHODS: This study used a longitudinal qualitative content analysis of narrative comments by attending physicians during real-time direct observation milestone evaluations of residents. Comments were collected over 2 years from 1 ACGME-accredited EM training program. RESULTS: In total, 1317 direct observation evaluations with comments from 67 faculty members were collected for 47 postgraduate year 3 EM residents. Analysis of the comments revealed that the ideal EM resident possesses many stereotypically masculine traits. Additionally, examination of a subset of the residents (those with 15 or more comments, n = 35) showed that when male residents struggled, they received consistent feedback from different attending physicians regarding aspects of their performance that needed work. In contrast, when female residents struggled, they received discordant feedback from different attending physicians, particularly regarding issues of autonomy and assertiveness. CONCLUSIONS: Our study revealed qualitative differences in the kind of feedback that male and female EM residents received from attending physicians. The findings suggest that attending physicians should endeavor to provide male and female residents with consistent feedback and guard against gender bias in their perceptions of residents' capabilities.

The legal control of marginal groups is a central topic in social scientific and legal scholarship. Examining the most influential research produced over the past two decades, as well as a broad collection of foundational and exemplary texts, this review addresses two overarching questions: First, what does it mean to study the legal control of marginal groups in the twenty-first century? Second, what are the recent developments, lingering concerns, and future directions of this work? We identify and examine the two most prevalent discussions found in contemporary research. The first centers on the practices of legal control, and the second focuses attention on the effects of these practices on their potential targets. Throughout the article, we draw specific attention to the need for future studies to more systematically account for the agency of, and ground-level dynamics impacting, both the controllers and the controlled.

Research suggests that suicide can socially diffuse through social relationships and social contexts; however, little is known about the mechanisms that facilitate this diffusion. Using data from an in-depth case study of a cohesive community with an enduring youth suicide problem (N = 118), we examine how, after repeated exposure to suicide, the community’s cultural script for suicide may have been rekeyed such that suicide became a more imaginable option for some community youth. Essentially, we found evidence that a series of sudden, shocking, suicide deaths of high-status youth may have triggered the formation of new locally generalized meanings for suicide that became available, taken-for-granted social facts. The new meanings reinterpreted broadly shared adolescent experiences (exposure to pressure) as a cause of suicide facilitating youth’s ability to imagine suicide as something someone like them could do to escape. We conclude by discussing the implications of our findings for the scientific understanding of (1) suicide and suicide clusters, (2) social diffusion processes, and (3) suicide prevention.