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The major purpose of this article is to explore the substantial disparity between access to resources provided at birth to a child with spina bifida--a so-called Baby Doe--and later access to resources needed to sustain that child throughout the life course. The author's organizing principle is the allocative paradoxes created by the clash of technology, scarcity, and demography. The study is based on an eight-year inquiry into the way life-saving medical decisions are made about children with spina bifida. This work focuses on the qualitative aspects of that inquiry. There is a societal need to debate health care rationing, to do much more systematic technology assessment, and to develop a much more consistently rational system of health care delivery.  相似文献   
103.
Mortality experienced in the first three years of follow-up for three Established Populations for Epidemiologic Studies of the Elderly (EPESE) is examined in relation to the participants' self-reported functional ability. In East Boston, Massachusetts (N = 3,812), Iowa and Washington Counties, Iowa (N = 3,673), and New Haven, Connecticut (N = 2,812), noninstitutionalized persons aged 65 and older were asked a series of questions to determine their functional status. These measures, used in logistic regression analyses of the mortality data, showed that an increased number of reported disabilities significantly increased the risk of mortality over and above the effects of the age and sex of the participant, or the methodological differences among the sites. Disabilities in gross mobility (e.g., ability to walk a half mile, climb stairs, or perform heavy work around the house) were more strongly related to mortality than were measures of activities of daily living.  相似文献   
104.
Democratic theorists and social scientists suggest that a deliberative public sphere would be good for democracy by maximizing emancipatory possibilities and providing broad legitimacy to political decision making. But do ordinary Americans actually want a deliberative public sphere? I examine this question in the context of four contentious “religion and science” debates. Through a multidimensional evaluation exercise with 62 ordinary respondents, I find that evaluation of public representatives in these debates tends to favor open‐mindedness and ongoing debate. Further, respondents explicitly discount elected representatives who participate in public debate precisely because they are seen as violating deliberative norms through their affiliation with electoral politics. Respondents want a deliberative public sphere. However, this desire reflects an understanding of the public sphere and institutional politics as disconnected arenas with incompatible rules and objectives, raising multiple questions for democratic theory and for political sociology.  相似文献   
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In the late 1980s and early 1990s, much attention was paid by British agricultural geographers to the restructuring of the farm sector under pressures of national, European and global change. The need to adopt a perspective capable of looking beyond the farm gate inspired the introduction of modified political economy approaches into agricultural research. One important cornerstone of the empirical application of this thesis was the concept of the ‘farm adjustment strategy’. This attempted to map out the responses, especially those of survival, made by farm family businesses to rapidly changing agrarian conditions. Subsequently, the farm adjustment strategy became remarkable for its popularity as a way to organise research into agricultural change in developed market economies. Following a retreat in the 1990s, there has been something of a recent revival in the use of the term ‘strategy’ relating to agricultural adjustment. Revisiting this concept is therefore timely. Using empirical evidence from studies of farming change in the Welsh Marches, this paper examines two issues. First, it makes a critical re-examination of the concept to resolve differences with interpretation linked to theoretical perspectives so that future misuse can be minimised. Second, an attempt is made to assess the relevance of defined elements of farm adjustment strategies to analyses of farm business change. In so doing, there is an attempt to recover our knowledge of agrarian restructuring and to help situate newly encultured investigations into the likely survival of family labour-based forms of production.  相似文献   
107.
This study examined both differential patterns and the stability of infants' (N = 70) distress reactivity across mother and stranger arm‐restraint conditions when infants were 6 and 9 months of age. Reactivity measures included observational variables for the rise, intensity, and duration of infant distress as well as motor activities associated with escape behaviors. Correlation analyses revealed that infant behaviors during arm restraint were modestly stable across conditions and over time; however, mean comparisons also showed that infants' distress responses appear to be sensitive to protocol parameters (whether restrainer is mother or stranger). At 6 months of age, infants cried more during maternal restraint than with strangers and exhibited escape behaviors more frequently with mothers. Findings further indicate that infants' distress reactivity undergoes developmental alterations from 6 to 9 months of age, with infants crying more quickly, reaching peak intensity of distress faster, and displaying more distress at 9 months compared to 6 months. These changes in infants' reactivity were particularly accentuated during maternal compared to stranger restraint conditions at 9 months of age.  相似文献   
108.
Objective: We examine how sexual activity relates to sexual well-being within the context of sexual attitudes, sexual agency, and sexual desire. Participants/Methods: We surveyed 471 college women in 2012–2014 who had ever had sex. Results: Sexual agency and sexual desire consistently predicted well-being, regardless of recent sexual activity. There was a significant interaction between recent sexual activity (none, casual, or exclusive relationship) and sexual attitudes. Exclusive sex was associated with higher than average sexual well-being, especially for women with permissive attitudes. Women who had casual sex and held permissive to average attitudes had the next highest levels of well-being, but those with non-permissive attitudes fell substantially below the overall mean. Women who had no recent sex were consistently below the mean, especially for women with more permissive attitudes. Conclusions: A disconnect between sexual attitudes and recent sexual activity may lower women's sexual well-being.  相似文献   
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