The escalation of the opioid epidemic in the United States has sparked sweeping legislation meant to regulate physicians' opioid prescribing practices. The demands of such policies force physicians to initiate discussions that could jeopardize the collaborative doctor- patient relationships necessary for curbing inappropriate opioid prescriptions. Drawing on sociopragmatics, this discourse analysis study of primary care interactions examines the face- saving linguistic features employed by physicians in negotiating the line between policy demands and maintaining collaborative relationships. The findings reveal several face-saving acts‚"pseudo requests, downtowners, broadening, redirection, tag questions, impersonalization, listing, and (negative) imagery‚"used by physicians when enacting the three most prominent policies: (1) monitoring opioid use, (2) prescribing anti-overdose medication, and (3) transitioning patients from opioids to alternative treatment. Informed by Goffman's concept of "face-work," this study provides evidence of the communicative burden placed on physicians implementing disagreeable opioid policies, as well as opening up discussions on how policymakers and medical institutions can support physicians in implementing opioid policies. Keywords: opioids, face-work, face threats, medical discourse, doctor-patient interaction, discourse analysis, sociopragmatics

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor- patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing prosodic discourse analysis to examine context-specific linguistic features used by the interlocutors of two distinct medical interactions. We found that patients employed both low pitch and creak as linguistic resources when describing chronic pain, narrating symptoms, and requesting opioids. The situational use of both features informs us about the linguistic ways in which patients frame fraught issues like chronic pain in light of the current opioid crisis. This study expands the breadth of phonetic analysis within the domain of discourse analysis, serving to illuminate discussions surrounding the illocutionary role of the lower vocal tract in expressing emotions.

The present study uses corpus-assisted discourse analysis to examine the role of modality in policy verb phrases, using California opioid policies as a case study. By tracking the behavior of permissive and restrictive modals across time, this study highlights two potential discourse functions of modals in policy drafting: (i) to reflect the gravity of the issues on the ground, and (ii) to express permission and restriction by highlighting and deemphasizing a policy's suggestive intent, respectively. This study shows that the increased use of restrictive modality has significant positive correlations with California's worsening opioid crisis and its rising fatalities. A closer examination of state policy amendments reveals that altering policy modals has the potential to either broaden or limit the terms of existing policies. Informed by Van Dijk's “context models,” this study provides a cogent applied corpus linguistics framework for analyzing policy text and offers both political and linguistic perspectives into our understanding of modals and how communities address epidemics, respectively.

Patient-clinician interactions are central to technical and interpersonal processes of medical care. Video recordings of these interactions provide a rich source of data and a stable record that allows for repeated viewing and analysis. Collecting video recordings requires navigating ethical and feasibility constraints; further, realizing the potential of video requires specialized research skills. Interdisciplinary collaborations involving practitioners, medical educators, and social scientists are needed to provide the clinical perspectives, methodological expertise, and capacity needed to make collecting video worthwhile. Such collaboration ensures that research questions will be based on scholarship from the social sciences, resonate with practice, and produce results that fit educational needs. However, the literature lacks suggested practices for building and sustaining interdisciplinary research collaborations involving video data. In this paper, we provide concrete advice based on our experience collecting and analyzing a single set of video-recorded clinical encounters and non-video data, which have so far yielded nine distinct studies. We present the research process, timeline, and advice based on our experience with interdisciplinary collaboration. We found that integrating disciplines and traditions required patience, compromise, and mutual respect; learning from each other enhanced our enjoyment of the process, our productivity, and the clinical relevance of our research.

As Durham’s economy collapsed in the mid-1990s, Duke established a plan to intervene. Its actions aligned with anchor institution models at many universities; its approach, however, was unique: In a city where Duke was a fixture, university leadership understood a top-down approach was not viable. Instead, administrators launched a community-led model intended to change the “story [from] look at what Duke did,” to “can you imagine what’s happened in Durham?”. I use a longitudinal case study to examine Duke’s anchor institution model in 12 Durham neighborhoods. The research considers Duke’s approach from the mid-1990s to present, drawing from: interviews with Duke administrators, community organizations, and neighborhood representatives; newspaper articles and reports; and a descriptive analysis of neighborhood change. This case explores an anchor model that engages non-profit partners and community development strategies. Findings show the potential for a multi-partner anchor model that cultivates neighborhood improvement and minimizes (to an extent) gentrification pressures that can arise from anchor investment. Duke’s anchor model offers a unique perspective on university-community engagement, partnerships and neighborhood investment.

Duke’s case offers insights for how major institutions—from university anchors to local government—can recast their roles in communities; it also offers a roadmap for how institutions can engage (and benefit) neighborhoods in meaningful ways. Informed by a collaborative anchor model, Duke empowered residents to identify their own neighborhood priorities and partnered with local community organizations to meet those aims. This anchor model reveals a powerful role for intermediaries, including planners and community organizers, to connect institutional resources with neighborhood priorities. Supported by a participatory planning process, there are opportunities to realign anchor institution strategies and tools with neighborhood priorities to move towards mutually beneficial outcomes.

This article reviews the concept of shared equity homeownership (SEH) in the United States. The review examines the origins of the SEH model and its historic precedents. It considers the impetus for SEH, setting the discourse within the context of US housing policy and, specifically, low-income homeownership research. Subsequently, the review assesses the current state of SEH research, including the evidence associated with SEH as an affordable housing strategy, its application and challenges in the field, and gaps in the scholarly discourse.

Town-gown engagement has evolved over several eras, most recently embodying the anchor institution model. The post-1990 scholarship suggests a distinct shift, describing a new framework for the ways universities engage with neighborhood space. This paper tests this approach, using a survey of universities to question several assumptions about town-gown engagement in the 21st century. While the conceptual definition and stylistic approach to engagement has changed, there appears to be less differentiation from earlier models than one might expect. The study offers a typology of university revitalization strategies and contributes a new perspective to the anchor institution discourse.

Problem:
Universities are pursuing place-making beyond the campus. In the 21st century, many universities have invested in revitalization, reconceiving of urban neighborhoods as assets, rather than detriments. But what does this mean for the neighborhood?

Research Strategy:
This study uses Census data and a survey of universities, pursuing neighborhood revitalization in nineteen cities, to examine place-based outcomes. I rely on median home values and rents to evaluate market change (1990 to 2010), testing how the rate of change in target tracts compares to areas without university investments. To account for contextual variation, I employ a multi-dimensional typology to analyze changes by city markets and revitalization approach.

Findings:
The findings illustrate how extending the university brand into neighborhoods, achieved through bricks-and-mortar projects, is an effective strategy for revitalization. University initiatives, regardless of their intensity or place-based focus, meaningfully impacted neighborhood housing markets. However, market appreciation was substantially greater for target areas located in strong-market cities and/or with high-intensity investment from a university.

Takeaway for Practice:
The findings contribute to an understanding of university revitalization outcomes and offer insight into the importance of context. For instance, strong market cities, on their own, are an indicator of success. University investment, in any form, appears to close gaps and boost lower-value neighborhoods back into an otherwise strong marketplace. For moderate and weak cities, the university’s approach is the defining characteristic—investment in place-based projects is critical for an improved market. Thus, the key to revitalization “success” is two-fold. Either the city is strong, enabling the university invest at any level of intensity, or the university pursues a place-based approach that increases the likelihood of growth regardless of city context. These outcomes highlight the potential for market-boosting effects, but also demonstrate the unique opportunity for planners to moderate housing market pressures alongside anchor institution investments.

University investments are expanding to incorporate neighborhood revitalization. Yet, there is an inadequate understanding of how “town” is impacted by “gown” initiatives. This study combines institutional data with 1990 and 2010 Census metrics to assess outcomes of university-led revitalization in twenty-two neighborhoods. It explores market and socioeconomic change for target tracts relative to others. While the literature hypothesizes that anchor institution initiatives improve communities, the findings complication that notion. Median home values increased substantially and were no longer statistically different from other tracts; median rents nearly closed the gap as well. However, socioeconomic indicators did not suggest fundamental change.