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If the thread that connects these papers one to another is the theme of violence and social struggle, they are at the same time quite diverse in approaches and subject matters. So diverse, in fact, that in order to see how they present material on violence and social struggle, we must begin by situating the variety of sociocultural material they bring to our attention in the story-lines, as it were, of their respective approaches. This grouping, or re-grouping, of the papers will, I think, lead us to seeing what is involved in giving what we might term an adequate pragmatic account of the phenomena they treat, though it is not my intention here to give an actual re-analysis of the various materials. My purpose is rather to be able to relate such criteria of adequacy to the particular commitments we have as social scientists to elucidating and thereby engaging with conditions that people more generally face in the inherent politics of sociocultural experience.

Without wishing to commit the etymological fallacy in the understanding of a word's meaning, I would like first to comment on the traditions of usage of the term ideoloqv, a theme elegantly announced in Woolard's introductory discussion of "issues and approaches." As is well known, it was Antoine Louis Claude Comte Destutt de Tiacy (1754-1836) who invented the term, in that naturalizing move of the French Enlightenment rendition of l,ocke (or, to be sure, Condillocke) that sought to understand human "nature." Ideology was proposed as that special branch of zoology that recognizes the condition of humans, we animals who have ideas as the content of what we should call our minds. Central here is the fact that any ideas more developed than physiological sensations are dependent on such ideas'being clothed in signs, the organization of which by some systematic grammar allows the discursive xpression of a logical faculty of mind. Hence, for Destutt de Tiacy, there is the general scientific field of ideology proper, the science of ideas, of which the subfield of grammar studies the signiffing externalizations, as it were, in structured systems of articulated signs, and the subfield of logic the modes of rationality oriented to truth and certitude of inferential states of mind (i.e., formation and combinatorics of ideas). Such a science would, for its propounder, also allow us to diagnose and understand "the causes of incertitude and flogical] error," thus presumably leading to an amelioration of the human condition vis-d-vis its natural mental faculties. It is particularly interesting, therefore, to see the fate of this term, proposed as a formation parallel to any of the other "-ologies" of a systematic scientific outlook. It has obviously become a word that now denotes a part or aspect of Destutt de Tiacy's very object of investigation, and in many appearances has the specifically "pejorative" use to pick up on Jane Hill's invocation of Raymond Geuss (1981: 12-22) that presupposes we know certain ideas to be dubious, in error, and

ImportancePatients with unmet health-related social needs are at high risk for preventable health care utilization. Prior interventions to identify health-related social needs and provide navigation services with community resources have not taken place in pharmacy settings.ObjectiveTo evaluate an enhancement of pharmacy care to reduce hospital admissions and emergency department (ED) visits among primary care patients in a Medicaid accountable care organization (ACO).Design, Setting, and ParticipantsThis nonrandomized controlled trial was conducted from May 1, 2019, through March 4, 2021, with 1 year of follow-up. Study allocation was determined by odd or even medical record number. The study was performed at a general internal medicine practice at a large safety-net hospital in Boston, Massachusetts. Patients who qualified for the hospital’s pharmacy care program (aged 18-64 years and within the third to tenth percentile for health care utilization and cost among Medicaid ACO membership) who attended a visit with a primary care clinician were eligible. Of 770 eligible patients, 577 were approached, 127 declined, and 86 could not be contacted.InterventionsPatients in the control group received usual pharmacy care focused on medication adherence. Patients in the intervention group received enhanced pharmacy care with an additional focus on identification of and intervention for health-related social needs. The intervention took place for 1 year.Main Outcomes and MeasuresThe primary outcome was inpatient hospital admissions and ED visits (composite outcome) in the 12 months after enrollment during the intervention period.ResultsAmong 364 allocated patients (mean [SD] age, 50.1 [10.1] years; 216 women [59.3%]), 35 were Hispanic of any race (9.6%) and 214 were non-Hispanic Black (58.8%). All participants were included in the intention-to-treat analysis. In analyses controlling for baseline hospital admissions and ED visits the year prior to enrollment, the enhanced pharmacy care group was not associated with the odds of having any hospital admission or ED visit (adjusted odds ratio, 0.62 [95% CI, 0.23-1.62]; P = .32) among all patients and was not associated with the visit rates among those with any visit (adjusted rate ratio, 0.93 [95% CI, 0.71-1.22]; P = .62) relative to the usual pharmacy care group in the year following enrollment.Conclusions and RelevanceThe findings of this nonrandomized controlled trial suggest that inpatient and ED utilization among Medicaid ACO members at a safety-net hospital was not significantly different between groups at 1-year follow-up.Trial RegistrationClinicalTrials.gov Identifier: NCT03919084

Language enables us to represent our world, rendering salient the identities, groups, and categories that constitute social life. Michael Silverstein (1945–2020) was at the forefront of the study of language in culture, and this book unifies a lifetime of his conceptual innovations in a set of seminal lectures. Focusing not just on what people say but how we say it, Silverstein shows how discourse unfolds in interaction. At the same time, he reveals that discourse far exceeds discrete events, stabilizing and transforming societies, politics, and markets through chains of activity. Presenting his magisterial theoretical vision in engaging prose, Silverstein unpacks technical terms through myriad examples – from brilliant readings of Marcel Marceau's pantomime, the class-laced banter of graduate students, and the poetics/politics of wine-tasting, to Fijian gossip and US courtroom talk. He draws on forebears in linguistics and anthropology while offering his distinctive semiotic approach, redefining how we think about language and culture.

ImportanceThe US Preventive Services Task Force recommends screening adults for depression in settings with programs in place to ensure receipt of appropriate care. Best practices regarding how to ensure such care are unknown, particularly for pregnant and postpartum persons.ObjectiveTo compare the effectiveness of 2 strategies for the initial management of screen-detected peripartum depressive symptoms.Design, Setting, and ParticipantsThis randomized comparative effectiveness trial was performed from February 1, 2018, to June 30, 2020, at the prenatal clinic, postpartum unit, and pediatric clinic within an urban safety-net hospital. Participants included peripartum persons with positive depression screen results. Data were analyzed from July 6, 2020, to September 21, 2022, based on intention to treat.InterventionsEngagement-focused care coordination (EFCC), which used shared decision-making and motivational techniques to refer patients to outside mental health services, and problem-solving education (PSE), a brief cognitive-behavioral program delivered at the screening site.Main Outcomes and MeasuresThe primary outcome consisted of severity of depressive symptoms; secondary outcomes included severity of anxiety symptoms and engagement with care, each measured bimonthly over 12 months. Rates of symptom elevations were modeled using negative binomial regression; rates of symptom trajectories were modeled using treatment × time interactions.ResultsAmong the 230 participants (mean [SD] age, 29.8 [5.8] years), 125 (54.3%) were Black and 101 (43.9%) were Hispanic or Latina. At baseline, 117 participants (50.9%) reported at least moderately severe depressive symptoms (Quick Inventory of Depressive Symptomatology score ≥11), and 56 (24.3%) reported clinically significant anxiety symptoms (Beck Anxiety Inventory score ≥21). Across 6 assessment time points, the mean (SD) number of moderately severe depressive symptom episodes in EFCC was 2.2 (2.2), compared with 2.2 (2.1) in PSE, for an adjusted rate ratio (aRR) of 0.95 (95% CI, 0.77-1.17). The mean (SD) number of anxiety symptom elevations in EFCC was 1.1 (1.8), compared to 1.1 (1.6) in PSE, for an aRR of 0.98 (95% CI, 0.69-1.39). There were significant treatment × time interactions relative to mean depressive symptom scores (−0.34 [95% CI, −0.60 to −0.08]; P = .009 for interaction term), favoring EFCC. There were no differences in engagement with care.Conclusions and RelevanceIn this randomized comparative effectiveness trial, there were no differences in depressive or anxiety symptom burden across comparators; however, the evidence suggested improved depressive symptom trajectory with immediate referral. Further work is necessary to guide approaches to management following depression screening for peripartum persons.Trial RegistrationClinicalTrials.gov Identifier: NCT03221556

Countering evolutionary and racist notions that languages of so-called primitive peoples lacked determinate sounds, just as they were held to lack expectable categories of morphosyntax, Boas demonstrated that every language has a phonetic (i.e., phonological) system of categories of sound that serves as the apperceptional grid for the production and reception of language. Sapir elaborated the ‘psychological reality’ of a structured system of ‘true points of the phonetic pattern’ on the basis of a distributional analysis of a combinatoric grammar of sound, contrasting such an abstraction from the minutiae of token phonetic variations in measurable articulation. Bloomfield, conceptualizing phonological segments as bundles (Boolean combinations) of ‘distinctive features’, systematized and codified the synchronic phonological perspective of distributionalism, re-thinking Neogrammarian doctrine in its terms. In all their descriptive work, these theorists worked across the gradient boundaries of what later—among their students and successors—became the problematic and controversial distinction between ‘phonemic’ and ‘morphophonemic’.

The US Preventive Services Task Force (USPSTF) works to improve the health of people nationwide by making evidence-based recommendations for preventive services. Patient-centered care is a core value in US health care. Shared decision-making (SDM), in which patients and clinicians make health decisions together, ensures patients' rights to be informed and involved in preventive care decisions and that these decisions are patient-centered. SDM has a role across the spectrum of USPSTF recommendations. For A or B recommendations (judged by the USPSTF to have high or moderate certainty of a moderate or substantial net benefit at the population level), SDM allows individual patients to decide whether to accept such services based on their personal values and preferences. For C recommendations (indicating at least moderate certainty of a small net benefit at the population level), SDM is critical for individual patients to decide whether the net benefit for them is worthwhile. For D recommendations (reflecting at least moderate certainty of a zero or negative net benefit) or I statements (low certainty of net benefit), clinicians should be prepared to discuss these services if patients ask. More evidence is needed to determine if, in addition to promoting patient-centeredness, SDM reduces inequities in preventive care, as well as to define new strategies to find time for discussion of preventive services in primary care.

The purpose of this study was to examine associations between maternal trauma exposure, posttraumatic stress symptoms, and directly observed maternal-child interactions among a diverse cohort of mother-preterm infant dyads at 12-month corrected age.We conducted a retrospective cohort study. Maternal trauma exposure and posttraumatic stress symptoms were measured using the Modified Posttraumatic Stress Disorder Symptom Scale at baseline and 6 and 12 months. The primary outcome was directly observed maternal-child interactions at 12-month corrected age using the Coding Interactive Behavior Manual. We used linear regression models to estimate the associations between trauma exposure, posttraumatic stress symptoms (and symptom clusters), and observer-rated maternal-child interactions.Among the 236 participants, 89 (37.7%) self-reported as Black and 98 (41.5%) as Latina; mean gestational age of the infants was 31.6 weeks (SD 2.6). Mothers with posttraumatic stress symptoms demonstrated greater maternal sensitivity (β = 0.32; 95% confidence interval [CI], 0.06-0.58; standardized effect size = 0.39) and greater dyadic reciprocity (β = 0.39; 95% CI, 0.04-0.73; standardized effect size = 0.36) compared with those not exposed to trauma; however, we did not observe significant differences between trauma-exposed but asymptomatic women and those not exposed to trauma. Across symptom clusters, differences in maternal sensitivity and dyadic reciprocity were most pronounced for mothers with avoidance and re-experiencing symptoms, but not hyperarousal symptoms.Maternal posttraumatic stress symptoms seem to be associated with the quality of maternal-child interactions at age 1 year among a cohort of urban, mother-preterm infant dyads. These findings have implications for strength-based intervention development.

Eating disorders (eg, binge eating disorder, bulimia nervosa, and anorexia nervosa) are a group of psychiatric conditions defined as a disturbance in eating or eating-related behaviors that impair physical or psychosocial functioning. According to large US cohort studies, estimated lifetime prevalences for anorexia nervosa, bulimia nervosa, and binge eating disorder in adult women are 1.42%, 0.46%, and 1.25%, respectively, and are lower in adult men (anorexia nervosa, 0.12%; bulimia nervosa, 0.08%; binge eating disorder, 0.42%). Eating disorder prevalence ranges from 0.3% to 2.3% in adolescent females and 0.3% to 1.3% in adolescent males. Eating disorders are associated with short-term and long-term adverse health outcomes, including physical, psychological, and social problems.The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for eating disorders in adolescents and adults with a normal or high body mass index. Evidence limited to populations who are underweight or have other physical signs or symptoms of eating disorders was not considered. The USPSTF has not previously made a recommendation on this topic.Adolescents and adults (10 years or older) who have no signs or symptoms of eating disorders (eg, rapid weight loss, weight gain, or pronounced deviation from growth trajectory; pubertal delay; bradycardia; oligomenorrhea; and amenorrhea).The USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of screening for eating disorders in adolescents and adults. The evidence is limited and the balance of benefits and harms cannot be determined.The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for eating disorders in adolescents and adults. (I statement).

Atrial fibrillation (AF) is the most common cardiac arrhythmia. The prevalence of AF increases with age, from less than 0.2% in adults younger than 55 years to about 10% in those 85 years or older, with a higher prevalence in men than in women. It is uncertain whether the prevalence of AF differs by race and ethnicity. Atrial fibrillation is a major risk factor for ischemic stroke and is associated with a substantial increase in the risk of stroke. Approximately 20% of patients who have a stroke associated with AF are first diagnosed with AF at the time of the stroke or shortly thereafter.To update its 2018 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the benefits and harms of screening for AF in older adults, the accuracy of screening tests, the effectiveness of screening tests to detect previously undiagnosed AF compared with usual care, and the benefits and harms of anticoagulant therapy for the treatment of screen-detected AF in older adults.Adults 50 years or older without a diagnosis or symptoms of AF and without a history of transient ischemic attack or stroke.The USPSTF concludes that evidence is lacking, and the balance of benefits and harms of screening for AF in asymptomatic adults cannot be determined.The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AF. (I statement).