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971.
972.
Stephen Scher Kasia Kozlowska 《Australian and New Zealand Journal of Family Therapy》2011,32(1):15-32
The bioethics movement has long promulgated a model of ‘principled decision‐making’ in which ethical dilemmas and conflicts between various rights, interests, and ethical principles are central. In many respects this movement has had a laudatory impact on health care and on health professionals, but we will also argue that the bioethical model of ethical analysis has important limitations. The model's theoretical orientation is discontinuous with the training and skills of health professionals, the manner in which health professionals conceptualise and solve problems that arise in a clinical setting, and the time constraints inherent in most clinical situations. As such, the model is not readily applicable to much of the day‐to‐day work of clinicians and, in particular, to the routine ethical questions and situations that arise in caring for patients. What we suggest is that the bioethical model does not take into account that health care professionals, as part of their daily work, encounter and manage difficult, often conflictual situations and that they do so by bringing to bear conceptual frameworks and therapeutic techniques that have, embedded within them, the ethical values and goals of their own fields, as well as established ways of dealing with problems and addressing competing priorities. We further argue that from a systems perspective, the bioethical model and the pragmatic, problem‐focused ethical decision‐making of clinicians operate on different levels of complexity; whereas the former is especially appropriate for situations that resist consensus or that raise significant issues of public policy, the latter serves as an effective framework in less difficult or complex situations that can be moved effectively toward consensus and closure. 相似文献
973.
Colin Almeleh Ph.D. 《Social Dynamics》2013,39(2):136-169
Abstract This study explores the bio-psychosocial context of HIV/AIDS in which eleven HIV-positive activist women from Khayelitsha negotiated the process of disclosing their HIV-positive status to significant others, specifically biological household members. The study is based on the narratives of a group of HIV-positive peer-educators in Cape Town, South Africa. The results suggest that community perceptions of HIV/AIDS are shaped by a wide variety of factors particular to the socio-cultural and political context of HIV/AIDS in South Africa. The process and outcomes of disclosure to others occurs within this shifting web of meanings, and in turn, reshapes them as people respond to the person who has just disclosed. Eight out of the eleven women disclosed to a close biological household member as these significant-others provided, or had the potential to provide, the appropriate support. Six of the eleven participants disclosed during the symptomatic phases of HIV/AIDS, while five were asymptomatic at the time. Four of the five who disclosed when asymptomatic were diagnosed while pregnant and had never experienced severe opportunistic infections. Additionally, these same four disclosed some time after diagnosis (nine months > t < two years). Of the six who disclosed in a state of ill-health, five disclosed immediately after diagnosis in order to access health-related social support. At this time, concerns regarding health and mortality superseded fears of rejection and discrimination due to AIDS-related stigma. The perceived potential benefits (social and health-related support) outweighed the perceived risks (stigmatisation and discrimination). When participants had never experienced serious illness, they disclosed in order to educate loved-ones, gain emotional support or challenge false popular perceptions of HIV/AIDS. 相似文献
974.
James R. Hillard M.D. Cherie L. Kitchell L.C.S.W. U. G. Turner III M.D. Richard P. Keeling M.D. Rebecca F. Shank M.Ed. 《Journal of American college health : J of ACH》2013,61(3):112-117
Abstract Genital herpes virus infection is an important target for health education efforts because of its apparently rising incidence in the college student population and because it can have potentially serious psychological as well as medical consequences. In order to better understand the health education and counseling needs of students, the present study surveyed knowledge and attitudes about genital herpes of 190 university students using a gynecology clinic and of 161 students using a general medical clinic. The students were found to have a high degree of familiarity with the disease, its cause, and mode of transmission, but tended to view the consequences of the disease as more severe than is actually warranted by the common medical complications. There was some degree of misinformation about prevention and treatment of the disease and some negative attitudes about patients suffering from it, but the survey respondents endorsed a high level of responsible behavior with regard to the disease and expressed some optimism about the possibility of adapting to it. These findings suggest specific misconceptions about genital herpes that might be amenable to a mass education approach. They also suggest the need for a counseling program that centers around reasonable reassurance and appropriately positive psychological and medical management for newly diagnosed patients. 相似文献
975.
This paper reviews qualitative data from academic research into prostitution, accounts from prostitutes themselves in the UK and Australia, and data from one of the authors' own research in New South Wales to analyse the ways in which female sex workers negotiate and construct their sense of themselves. This analysis is informed by the suggestion that, in the act of commercial sex, the prostitute's own body is being consumed by the client, which can be seen to place certain pressures on the relationship between sex workers' professional and personal identities. Our review suggests that individual workers' tactics for managing the contradictions of working as a prostitute and preserving self‐esteem are both similar and different, even within two broadly culturally commensurable contexts, and, moreover, that not all prostitutes necessarily want to maintain a strict divide between work sex and non‐work sex in every encounter. Moreover, even for those who do, the trials of maintaining the divide are considerable, as is the permeability of boundaries between work and intimate sex. 相似文献
976.
In a series of major papers culminating in A Theory of Justice, John Rawls constructs an alternative to utilitarianism by developing a social contract theory of moral and political philosophy. Unfortunately, Rawls formulates the two basic principles upon which the theory rests in such a way as to restrict (unduly) the contract theory's applicability (see Section I). In this paper we present a more general discussion of the theory of justice that avoids the problems of Rawls' formulation and yet retains the important idea of justice as fairness and the contractarian approach (Section II). Later it is argued that this more general theory constitutes a bridge between the pure utilitarian theories and the social contract doctrines (Sections V and VI). The theory's advantages are demonstrated by applying it to a problem discussed by Rawls, intergenerational equity, and comparing the two solutions (Section III). Further comparisons are made and inferences drawn in the concluding three sections.Without implicating them, we would like to thank James M. Buchanan and David Lyons for comments on an earlier draft of this paper.
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977.
Weak ties, particularly those to potential employers, play a more important role than strong ties in the immigration of professionals to the United States. I operationalize network strength through the class of admission variable in the Immigration and Naturalization Service's public use data files,Immigrants Admitted to the United States, 1972–1992. I also examine the differential impact of legislative measures on the availability of strong versus weak ties for four groups of professionals: physicians, nurses, engineers and scientists. Not only do weak ties figure heavily on the immigration experiences of professionals, but those impacts affect women differently than men. Professional women rely more heavily on strong ties than on weak ties when compared with males in their respective professions, with the exception of nursing. These findings suggests a need for further study into the migration experiences of professionals as well as more research into how gendered networks develop among immigrant professionals and how those networks influence (either positively or negatively) immigrant adaptation to United States' society. 相似文献
978.
This short‐term longitudinal study investigated 918 students' school‐related affect across the transition to high school. The study focused specifically on the moderating effect of change in student ethnic congruence from middle to high school. Results indicate that students experiencing more ethnic incongruence from middle to high school, in particular African American and male students, reported declining feelings of school belonging over time. Moreover, students experiencing ethnic incongruence also had increasing worries about their academic success. These results suggest that the changing school demographics from middle school to high school may negatively impact students' school‐related affect, especially if they move to high schools which include fewer students who are ethnically similar to themselves. 相似文献
979.
Stephen Boyden 《Innovation: The European Journal of Social Science Research》2001,14(2):103-116
The Nature, Society and History theme is discussed in terms of the conceptual framework of 'biohistory'. Reference is made to its relevance to human health and well-being, societal metabolism and ecological sustainability. The power of human culture as an ecological force is emphasized. The Nature, Society and History paradigm is discussed in the context of the social changes that will be necessary for the achievement of ecological sustainability. It is suggested that it has an essential contribution to make not only in the academic world, but also in the general community. 相似文献
980.
Bayesian Monte Carlo (BMC) decision analysis adopts a sampling procedure to estimate likelihoods and distributions of outcomes, and then uses that information to calculate the expected performance of alternative strategies, the value of information, and the value of including uncertainty. These decision analysis outputs are therefore subject to sample error. The standard error of each estimate and its bias, if any, can be estimated by the bootstrap procedure. The bootstrap operates by resampling (with replacement) from the original BMC sample, and redoing the decision analysis. Repeating this procedure yields a distribution of decision analysis outputs. The bootstrap approach to estimating the effect of sample error upon BMC analysis is illustrated with a simple value-of-information calculation along with an analysis of a proposed control structure for Lake Erie. The examples show that the outputs of BMC decision analysis can have high levels of sample error and bias. 相似文献