James Moody

Occupational prestige is typically studied as a hierarchy among occupations, but distinctions in status and recognition also emerge among forms of expertise within occupations. We examine how such distinctions are publicly narrated in the culinary profession through a qualitative analysis of the 127 substantive episodes of Chef’s Story, a series of extended interviews with prominent chefs, restaurateurs, and other culinary professionals recorded between 2012 and 2016. Using theoretically informed, iterative analysis, we compare recurring representations of savory and pastry labor while attending to countervailing cases. Both forms of expertise are portrayed as highly skilled, creative, and professionally valued, but they are associated with different forms of authority and recognition. Savory labor is more often linked to leadership, innovation, authorship, restaurant identity, and public visibility, whereas pastry labor is more often framed through precision, refinement, technical mastery, and specialized expertise. We describe these patterned relationships as a profession’s prestige architecture. The findings show how valued and interdependent forms of expertise acquire different degrees of symbolic centrality with little overt conflict, extending research on occupational prestige from differences among occupations to the organization of prestige within them.

Objective: Cardiometabolic diseases are rising in low‐ and middle‐income countries, which also bear high burdens of helminth infection and malnutrition. Untangling the relationships among helminth infection, energy status, and cardiovascular disease is important for reducing these burdens. Methods: We investigated the interacting risks and moderating variables associated with cardiometabolic health using demographic, health, and hookworm infection data from 874 participants in rural northeast Madagascar. Results: We observed wide variation in body‐mass index (BMI) and blood pressure, alongside high prevalences of two helminth infections: the human hookworm Necator americanus (53.6%) and the zoonotic hookworm Ancylostoma ceylanicum (20.4%). We hypothesized that hookworm infections would be associated with reduced BMI and lower blood pressure through energetic and immunomodulatory pathways. Yet, the two hookworm species showed different associations, with N. americanus infection negatively associated with BMI and A. ceylanicum infection positively associated with blood pressure. Wealthier individuals had higher BMI, but this positive effect was attenuated if they were infected with A. ceylanicum . Coinfection with both hookworms did not significantly modify these associations with BMI or blood pressure. Structural equation modeling indicated that N. americanus infection was associated with reduced blood pressure both directly and through its negative association with BMI, while A. ceylanicum infection was associated with increased blood pressure independent of BMI. Conclusions: Our findings shed new light on the interacting burdens of malnutrition, parasitism, and chronic diseases with implications for public health, highlighting that these associations are dependent on parasite species.

Being well liked by one’s peers is an important aspect of adolescent well-being and shapes school social systems. Researchers have consistently documented the correlates and consequences of being well liked, though mostly in Western samples from American or European schools. While prior research has focused largely on behaviors that either complement or conflict with institutional norms, we extend the scope of these investigations to health-related diet and weight in a unique sample of Saudi youth. We find that BMI is associated with peer acceptance differently for boys and girls: For girls, higher BMI is generally associated with lower peer acceptance across the entire range of BMI, consistent with a “thinner-is-better” norm. For boys, the relationship is statistically stronger and clearly curvilinear, with both underweight and overweight boys receiving fewer nominations than middle-weight boys. We find that reporting eating unhealthy foods is associated with greater peer acceptance for both males and females. Combined, these results suggest that Saudi girls may face contradictory expectations: to be well liked they must be thin, but students who eat non-fattening foods are less well liked.

Despite oral daily HIV pre-exposure prophylaxis (PrEP) effectiveness, uptake remains a challenge. Awareness of one’s HIV status and engagement in prevention is essential to interrupting transmission among populations at high risk of HIV. We explored gaps in HIV risk perception, screening, and PrEP uptake among high HIV-risk fishermen living and working along Lake Victoria, Kenya. Data are from the Owete study (NCT04772469), which evaluated the impact of secondary distribution of HIV self-tests and supported linkage to health facilities within social-networks on prevention engagement. Using self-reported sexual behavior data and clinical records, we (1) identified PrEP-eligible men based on self-reported sexual behavior, per Kenya national guidelines; (2) reported the proportion of fishermen who (a) linked to a healthcare facility post-testing, (b) initiated PrEP per clinic records; and 3) analyzed the relationship between PrEP eligibility and perceived HIV risk using logistic regression, controlling for socio-demographic characteristics. Among 733 fishermen, 715 were sexually active in the past 6 months. The median age was 37.2, 68.4% had ≤ primary education, and 87% were married. PrEP eligibility was prevalent (474; 65%); of eligible men, 222 (47%) linked to a healthcare facility after testing, of whom 127 (57%) received a confirmatory HIV test, 31 (14%) initiated PrEP and 2 (0.1%) were already on PrEP. Primary reasons for non-initiation include screening as low risk at the facility ( n = 66; 30%), declining PrEP ( n = 41; 18%), and stock-outs ( n = 5; 2%). Participants reporting moderate or high self-perceived HIV acquisition risk had 1.80 (95% CI: 1.09, 2.98, p = 0.023) and 1.75 (95% CI: 1.01, 3.03, p = 0.045) times the risk of screening as PrEP eligible, respectively, compared to those reporting no risk. A substantial proportion of fishermen were eligible for PrEP based on sexual behaviors self-reported during the study surveys which align with standardized PrEP eligibility criteria. Nevertheless, we identified a high discordance between these self-reported criteria which renders one PrEP eligible and actually screening PrEP-eligible at a healthcare facility, highlighting potential gaps in effective screening for and subsequent coverage of PrEP to men at risk for HIV acquisition. Understanding the potential limitations of current PrEP screening protocols, as well as clients’ experiences with PrEP screening in the clinic, may increase the sensitivity of PrEP screening and close gaps in effective PrEP coverage. Clinical Trial Registration : NCT04772469

Identifying individuals at high risk of infection is critical to guiding interventions during infectious disease outbreaks. Network centrality can characterize infection risk, but its utility varies across pathogens and social systems. We used equivalence-based blockmodeling to identify social-epidemiological roles associated with viral exposure among 1,297 adults in northeast Madagascar. Roles were determined based on social networks derived from reported shared free time and exchanges of food and farmwork. We identified three distinct role categories, including individuals with many reciprocated social ties (Popular), individuals who sent many ties with few reciprocated (Hangers-On), and individuals who had few connections (Periphery). To assess whether the role categories covaried with viral exposure, we performed Phage ImmunoPrecipitation Sequencing with VirScan using dried blood spot samples to determine exposure to 337 virus species and subtypes. Individuals in the Popular ( ß [95% CI]: 0.29 [−0.06-0.63]) and Hangers-On ( ß [95% CI]: 0.36 [0.12-0.60]) role categories had greater viral exposure than individuals in the Periphery role category. Roles performed better at predicting exposure than single measures of centrality. Equivalence-based blockmodeling extends the utility of network centrality for characterizing infection risk and provides new insights into how social roles relate to both pathogen exposure and susceptibility to infection.

Background: Place-based initiatives (PBIs) invest in a geographic area and often build community power to improve well-being. However, there can be differences in results for different groups within a community. Methods: In six communities, we measured differences in “power to” by race/ethnicity at two points for the first phase of the PBI Healthy Places North Carolina (HPNC) using five indicators: (1) representation in network of actors collaborating to improve health, (2) leadership attributes, (3) perceived change in attributes due to HPNC, (4) network centrality, and (5) perceived change in network ties due to HPNC. Results: Latine populations were underrepresented. In four (majority White) communities, there were indications of White advantage. In one, White centrality was greater than non-White. In another, White actors consistently rated themselves higher for leadership attributes. In two, a gap in leadership attributes favoring White actors appeared at Wave 2. In two counties with African American majorities, non-White attributes ranked higher than White. Conclusions: Each indicator provided unique insight. Results provide new evidence of measurement validity and reliability. Results indicate that when PBIs designed to address the needs of low-resource communities do not proactively concern themselves with racial/ethnic equity and power (as HPNC would do in the years after this study), they may result in greater White benefit from PBI or failure to close existing gaps. Findings aligned with the “political reality” model of the correspondence between the size of African American population and their perceived self-efficacy. Changes over time and inter-county differences confirm need for early measurement of power differences and changes.

Objectives: Understanding disease transmission is a fundamental challenge in ecology. We used transmission potential networks to investigate whether a gastrointestinal protozoan (Blastocystis spp.) is spread through social, environmental, and/or zoonotic pathways in rural northeast Madagascar.Materials and Methods: We obtained survey data, household GPS coordinates, and fecal samples from 804 participants. Surveys inquired about social contacts, agricultural activity, and sociodemographic characteristics. Fecal samples were screened for Blastocystis using DNA metabarcoding. We also tested 133 domesticated animals for Blastocystis. We used network autocorrelation models and permutation tests (network k‐test) to determine whether networks reflecting different transmission pathways predicted infection.Results: We identified six distinct Blastocystis subtypes among study participants and their domesticated animals. Among the 804 human participants, 74% (n = 598) were positive for at least one Blastocystis subtype. Close proximity to infected households was the most informative predictor of infection with any subtype (model averaged OR [95% CI]: 1.56 [1.33–1.82]), and spending free time with infected participants was not an informative predictor of infection (model averaged OR [95% CI]: 0.95 [0.82–1.10]). No human participant was infected with the same subtype as the domesticated animals they owned.Discussion: Our findings suggest that Blastocystis is most likely spread through environmental pathways within villages, rather than through social or animal contact. The most likely mechanisms involve fecal contamination of the environment by infected individuals or shared food and water sources. These findings shed new light on human‐pathogen ecology and mechanisms for reducing disease transmission in rural, low‐income settings.

Smoking declines are uneven around the world, and we have few studies on the correlates of youth smoking in contexts like Saudi Arabia, where declines have been slowest. Using a broadly socio-ecological framework and network data, we report on one of the few studies to simultaneously examine peer, family, and school features associated with smoking in the Saudi context. We find strong and consistent peer and family associations with both occasional and regular smoking via direct modeling (level of peers/family that also smoke) and substantive interactions (lying to parents in the family domain, engaging in unsupervised youth-centric activities, or seeking popularity in the peer domain). Although our design precludes causal claims, our results are consistent with smoking initiation being driven by occasional use surrounding attempts to gain youth social status, whereas regular use depends on implicit family and peer acceptance.