How Academic Community and an Ethic of Care Can Shape Adjunct Work Environments: A Case Study of a Community College

This article presents a qualitative case study that explores how faculty and administrators at one community college conceptualized and experienced academic community within their institution and how that conceptualization helped shape the part-time faculty work environment. Using a combined framework of academic community and care ethics, this study utilizes data from 55 interviews with full-time and part-time faculty and administrative leaders from a large community college. Findings from this study indicate that defining membership, a sense of belonging, and shared mission and goals are key components to their understanding of academic community. From these three components, the study found that when participants included adjunct faculty as members of their academic community, they also reported a sense of responsibility or obligation to supporting them.

     

现代医疗回归人文关怀的路径——以京东中美医院为例

愈演愈烈的医疗纠纷带来了诸多值得研究的现实课题,也引发了医疗机构的许多深层次思考。在现代医疗呼唤人文关怀回归的背景下,京东中美医院以文化为路径,进行了一系列的有益尝试。以实录的形式记录了京东中美医院人文关怀的点滴细节,以期探求细节背后的文化根源。介绍了京东中美医院“人本、仁爱、公益”的文化理念和极具特色的医院行为文化,在医院发展过程中,重视医院文化的建设和发展,是让现代医疗回归人文关怀的有效路径。     

美国围产期姑息照护探析——从一则医疗叙事谈起

以美国本土发生的一则围产期姑息照护案例的叙事为引线,展开对美国围产期姑息照护的介绍,并重点分析家庭一体化意识对围产期姑息照护的重要性和围产期姑息照护共情的内涵。认为围产期姑息照护要求医护人员具有共情能力和家庭一体化意识,从而为处于围产期胎儿具有致命或限制生命的畸形情形下的家庭提供超越生理层面的有益的生理和心理-社会-精神的支持。另外,叙事培育共情,因此通过叙事(将患者的想法纳入医疗照护),医务人员可以学习如何和患者产生共情以及培育家庭一体化意识。     

Why We Shouldn't Swallow Worm Slices: A Case Study in Semantic Accommodation

A radical metaphysical theory typically comes packaged with a semantic theory that reconciles those radical claims with common sense. The metaphysical theory says what things exist and what their natures are, while the semantic theory specifies, in terms of these things, how we are to interpret everyday language. Thus may we “think with the learned, and speak with the vulgar.” This semantic accommodation of common sense, however, can end up undermining the very theory it is designed to protect. This paper is a case study, showing in detail how one popular version of temporal parts theory is self‐undermining. This raises the specter that the problem generalizes to other metaphysical theories. The traditional flavor of temporal parts theory, Worm Theory, claims that everyday objects are four‐dimensional space‐time worms. An alternative flavor, Slice Theory, claims that objects are not space‐time worms but are instead momentary slices of these worms. The differences, we find, are not nearly as great as advertised. In fact, the differences in the two metaphysical theories are entirely masked by compensating differences in the accompanying semantic theories. As a result, the two theories generate exactly the same truth conditions. Common sense says that I was born years ago. Slice Theory adopts a semantic theory that accommodates such claims, but in doing so, it also endorses the claim that I, like other everyday objects, persist and thus do not exist for a mere moment. That is, the metaphysical claims constitutive of Slice Theory are denied by the very semantic theory Slice Theory adopts to accommodate common sense. Slice Theory thus undermines itself.     

Value Perceptions of Integrative Health Care: A Study of Primary Care Physicians and Professional Clinical Counselors

A study was conducted to identify value perceptions of primary care physicians and Professional Clinical Counselors on integrative health care. Surveys were collected from 54 primary care physicians and 33 Professional Clinical Counselors in Central Ohio. Quantitative and qualitative results indicate favorable perceptions and opportunities for professional collaboration.     

军事医学伦理中的友谊、群体和关怀

医学伦理禁止医务人员将患者划分等级.然而,在军事中,特别是战争境遇下,由于医疗资源匮乏,其医学伦理却要求首先救助同胞士兵.社群主义者、关怀伦理提出了针对同盟者、朋友和家人的特殊责任:在小群体成员有医疗关怀需求时,不管谁的伤势更重,道德都会要求优先治疗同胞士兵,而后才是同盟或敌方士兵.     

Power and Public Participation in a Hazardous Waste Dispute: A Community Case Study

Qualitative case study findings are presented. We examined whether public participation in a hazardous waste dispute manifested in ways consistent with theories of social power; particularly whether participatory processes or participants' experiences of them were consistent with the three-dimensional view of power (Gaventa, Power and powerlessness: quiescence and rebellion in an appalacian valley, 1980; Lukes, Power: A radical view, 1974; Parenti, Power and the powerless, 1978). Findings from four data sources collected over 3 years revealed that participatory processes manifested in ways consistent with theories of power, and participants' experiences reflected this. Results illustrated how participation was limited and how citizen influence could be manipulated via control of resources, barriers to participation, agenda setting, and shaping conceptions about what participation was possible. Implications for community research and policy related to participation in hazardous waste disputes are discussed.     

How to Pick Out a Dragon: Fiction and the Selection Problem

Topoi - Non-actualist theories promise straightforward accounts of meaning, truth and reference of fictional discourse but are ostensibly saddled with a Selection Problem, that multiple possible...     

Reaching Out: Improving the Continuity of Care of Community Mental Health Services Through a Weekly Climbing Group

This mixed-method study examined the impact of a novel activity group on engagement in care. Thirty-two participants were recruited from National Health Service (NHS) community mental health services in three inner-London boroughs. Participants undertook eight weekly sessions of supervised climbing. There was a significant quantitative improvement in the domain “individual progress” (Z = 2.12, p = 0.03). Qualitative data indicated a wide range of benefits. The study identified both direct and indirect benefits to continuity of care. The study validates the use of a climbing activity group to engage and benefit community mental health service users.     

The Effect of Group Psychotherapy in Reducing Resistance to Individual Psychotherapy: A Case Study

Abstract

Cohesion in group treatment of spouse abusers plays an important and often overlooked role. Involuntary abuser groups can benefit from cohesion, but due to their unique structure, cohesion may develop differently than in voluntary psychotherapy groups. Initially, abuser groups may develop premature levels of cohesion that can make group members unwilling to express conflict, develop intimacy, and take responsibility for their actions. Understanding the abuser personality and the unique characteristics of involuntary abuser groups can shed light on why cohesion develops the way it does and the importance it plays in abuser groups. Developing effective interventions that target premature cohesion can help the group members express conflict, develop intimacy, and take responsibility for their actions, thus bringing about therapeutic levels of cohesion.     

Merging Professional Training and Community Engagement Agendas: A Case Study

This case study explored the emancipatory foundations of community work through a schools-based peer support intervention. We use a case study approach to describe the context in which the intervention was developed, its emancipatory theoretical foundations, and the project's implementation components and process. The findings suggest that reflexivity is a useful tool for community engagement and for articulating tensions that arise in the enactment of community participation, empowerment and conscientisation. The intervention presented a unique opportunity to reflect on the operationalisation of theoretical concepts in community psychology, and to train professional psychologists for reflexive community work.     

The Lost Voice: How Libertarianism and Consumerism Obliterate the Need for a Relational Ethics in the National Health Care Service

This article analyzes the contribution Christian ethics mightbe able to make to the ethical debate on policy and caregivingin health and social care in the United Kingdom. The articledeals particularly with the concepts of solidarity and subsidiaritywhich are essential in Christian social ethics and health careethics, and which may be relevant for the ethical debate onhealth and social caregiving in the United Kingdom. An importantargument in the article is that utilitarian and market-drivenpolicies in the National Health Service (NHS) and the socialcare system have marginalized the position of the elderly andhave seriously impoverished the quality of care for the elderly.The neglect of the elderly and other vulnerable groups is alsothe result of widespread consumerist attitudes among patientsand of libertarian models of noninterference which are affirmedby a public ethos of self-sufficiency and counter-dependency.Those who need care dare not make their need known to othersand ask for help, while simultaneously those who could helpare so intimidated by the public affirmation of privacy andnegative rights that they do not dare to offer help except ifthis is explicitly demanded. This distant and standoffish attitudeis in an important way responsible for the fact that the voiceof those in need is altogether lost to the public forum. Christianethics puts much emphasis on responsibility and solidarity withthe needy other but is not able to have much impact on the deliveryof care in a secularized society and health care system likethe NHS. Nonetheless, Christianity still has a powerful andrespected voice, by speaking up for those who cannot speak forthemselves, such as the elderly and the handicapped. Christianscan find allies in the ethics of care and other relational approachesin health care ethics in order to combat libertarianism, consumerism,and utilitarianism.     

我国特需医疗服务发展基本思路探讨

针对我国特需医疗服务实施现状中存在的弊端,在重新界定特需医疗服务内涵的基础上,提出将医疗服务从所提供服务的普遍性角度划分为特需医疗服务与普通医疗服务,改变所有公立医院均可提供特需医疗服务的现状,只允许私立医院和一部分自负盈亏的企业型公立医院提供特需医疗服务的发展思路。     

我国特需医疗服务发展基本思路探讨

针对我国特需医疗服务实施现状中存在的弊端,在重新界定特需医疗服务内涵的基础上,提出将医疗服务从所提供服务的普遍性角度划分为特需医疗服务与普通医疗服务,改变所有公立医院均可提供特需医疗服务的现状,只允许私立医院和一部分自负盈亏的企业型公立医院提供特需医疗服务的发展思路.     

Medical Crisis Counseling on a Pediatric Intensive Care Unit: Case Examples and Clinical Utility

The intensive care unit is one of the most stressful and demanding work sites of the pediatric psychologist. The rapid changes in health status that necessitate stays on the intensive care unit often constitute an emotional roller coaster ride for both family members and the staff caring for their child. The Medical Crisis Counseling (MCC) intervention model is a useful approach to providing psychological support in the pediatric intensive care setting. A representative year's worth of consultation requests from the multidisciplinary intensive care unit of a large urban pediatric hospital is described and discussed in the context of the MCC model.     

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.