Amrapali Maitra’s research while affiliated with Brigham and Women's Hospital and other places

Background: Despite the high prevalence and significant health effects of intimate partner violence (IPV), little is known about its associations with hospitalization. Objective: To perform a scoping review of how IPV impacts hospitalization rates, characteristics, and outcomes in adult patients. Data sources: A search of four databases (MEDLINE, Embase, Web of Science, and CINAHL) using a combination of terms including hospitalized patients and IPV revealed 1608 citations. Study selection and data extraction: One reviewer determined eligibility based on inclusion and exclusion criteria, which a second reviewer independently verified. Data were extracted and organized a posteriori into three categories based on research aim: (1) comparative studies of hospitalization risk associated with recent IPV exposure, (2) comparative studies of hospitalization outcomes by IPV exposure, and (3) descriptive studies of hospitalizations for IPV. Results: Of the 12 included studies, 7 were comparative studies of hospitalization risk associated with IPV, 2 were comparative studies of hospitalization outcomes by IPV, and 3 were descriptive studies of hospitalizations for IPV. Nine out of 12 studies focused on specific patient populations. All but one study demonstrated that IPV was associated with increased risk of hospitalization and/or worse hospitalization outcomes. Six of the seven comparative studies showed a positive association between recent IPV and hospitalization risk. Conclusion: This review suggests that IPV exposure increases the risk of hospitalization and/or worsens inpatient outcomes in specific patient populations. Additional work is needed to characterize hospitalization rates and outcomes for persons who have experienced IPV in a broader, nontrauma population.

Unspeakability is a dominant analytic lens in scholarship on gendered violence in India, but women can and do speak out. This article examines how Bengali women complain about domestic violence through peter katha, the belly's word. The capacious pet (belly) is the seat of tension, where abuse dwells in the body. At a clinic in Kolkata, India, women describe sensations of abdominal pain, pressure, and hunger to convey patterns and temporalities of violence. Yet complaints of belly pain go unacknowledged by local clinicians. Hygiene discourses frame poor women's bodies, not structural violence, as the problem. Peter katha is more than an idiom of distress: it is a genre of embodied complaint that illuminates violence as the accrual of harm and, in its dynamic and layered quality, moves beyond a binary of disclosure or concealment. Anthropologists may use peter katha to extend the conceptual vocabulary of gender and silence. [domestic violence, kinship, complaint, hygiene, belly, India].

During ethnographic fieldwork in West Bengal, India, I witnessed the comingling of disgust and desire in shaping religious identity, the effervescent force of crowds, and moments of ordinary ethics enacted through labor. This short story is set in a fictional town: Gokulpur is a microcosm of the tension between rural idiosyncrasies and urban aspirations in India, permeated by growing right‐wing Hindu sentiments. Through the evolving relationship between a boy and his family's revered cow, I explore what it means to navigate companionship, community, and everyday life in an increasingly politicized village—and the reverberations of our choices. The piece originates from a desire to inhabit unfamiliar perspectives through closely observed characters and scenes, testing the potential and limits of imaginative empathy as a tool for social understanding. This work of fiction engages with anthropological scholarship on cross‐species friendship, nonhuman agency, religious ritual, and the ethics of care. [fiction, religion, India, animals, agency, ethics of care]

Objective Although social and environmental factors are central to provider–patient interactions, the data that reflect these factors can be incomplete, vague, and subjective. We sought to create a conceptual framework to describe and classify data about presence, the domain of interpersonal connection in medicine. Methods Our top-down approach for ontology development based on the concept of “relationality” included the following: 1) a broad survey of the social sciences literature and a systematic literature review of >20 000 articles around interpersonal connection in medicine, 2) relational ethnography of clinical encounters (n = 5 pilot, 27 full), and 3) interviews about relational work with 40 medical and nonmedical professionals. We formalized the model using the Web Ontology Language in the Protégé ontology editor. We iteratively evaluated and refined the Presence Ontology through manual expert review and automated annotation of literature. Results and Discussion The Presence Ontology facilitates the naming and classification of concepts that would otherwise be vague. Our model categorizes contributors to healthcare encounters and factors such as communication, emotions, tools, and environment. Ontology evaluation indicated that cognitive models (both patients’ explanatory models and providers’ caregiving approaches) influenced encounters and were subsequently incorporated. We show how ethnographic methods based in relationality can aid the representation of experiential concepts (eg, empathy, trust). Our ontology could support investigative methods to improve healthcare processes for both patients and healthcare providers, including annotation of videotaped encounters, development of clinical instruments to measure presence, or implementation of electronic health record-based reminders for providers. Conclusion The Presence Ontology provides a model for using ethnographic approaches to classify interpersonal data.

Objective Although social and environmental factors are central to provider patient interactions, the data that reflect these factors can be incomplete, vague, and subjective. We sought to create a conceptual framework to describe and classify data about presence, the domain of interpersonal connection in medicine. Methods Our top down approach for ontology development based on the concept of relationality included 1) broad survey of social sciences literature and systematic literature review of more than 20,000 articles around interpersonal connection in medicine, 3) relational ethnography of clinical encounters (5 pilot, 27 full) and 4) interviews about relational work with 40 medical and nonmedical professionals. We formalized the model using the Web Ontology Language in the Protege ontology editor. We iteratively evaluated and refined the Presence Ontology through manual expert review and automated annotation of literature. Results and Discussion The Presence Ontology facilitates the naming and classification of concepts that would otherwise be vague. Our model categorizes contributors to healthcare encounters and factors such as Communication, Emotions, Tools, and Environment. Ontology evaluation indicated that Cognitive Models (both patients explanatory models and providers caregiving approaches) influenced encounters and were subsequently incorporated. We show how ethnographic methods based in relationality can aid the representation of experiential concepts (e.g., empathy, trust). Our ontology could support informatics applications to improve healthcare such annotation of videotaped encounters, clinical instruments to measure presence, or EHR based reminders for providers. Conclusion The Presence Ontology provides a model for using ethnographic approaches to classify interpersonal data.

Background and objectives: Professionalism is essential in medical education, yet how it is embodied through medical students' lived experiences remains elusive. Little research exists on how students perceive professionalism and the barriers they encounter. This study examines attitudes toward professionalism through students' written reflections. Methods: Family medicine clerkship students at Stanford University School of Medicine answered the following prompt: "Log a patient encounter in which you experienced a professionalism challenge or improvement opportunity." We collected and analyzed free-text responses for content and themes using a grounded theory approach. Results: One hundred responses from 106 students generated a total of 168 codes; 13 themes emerged across four domains: challenging patients, interpersonal interactions, self-awareness, and health care team dynamics. The three most frequently occurring themes were interacting with emotional patients, managing expectations in the encounter, and navigating the trainee role. Conclusions: Medical students view professionalism as a balance of forces. While many students conceived of professionalism in relation to patient encounters, they also described how professionalism manifests in inner qualities as well as in health systems. Interpersonal challenges related to communication and agenda-setting are predominant. Systems challenges include not being seen as the "real doctor" and being shaped by team behaviors through the hidden curriculum. Our findings highlight salient professionalism challenges and identity conflicts for medical students and suggest potential educational strategies such as intentional coaching and role-modeling by faculty. Overall, students' reflections broaden our understanding of professional identity formation in medical training.

This cohort study examines interruptions by residents and faculty discussants during residency teaching conferences by gender.