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51.
Do the conditions under which promises are made determine whether they ought to be kept? Philosophers have placed a number of conditions on promising which, they hold, must be met in order to make promise-keeping obligatory. In so doing, they have distinguished valid promises from invalid promises and justified promises from promises that are not justified. Considering such conditions, one by one, we argue that they are mistaken. In the first place, the conditions they lay down are not necessary for either valid or justified promise-making. In the second place, promises need not meet such conditions in order to create moral obligations. In general, such analyses of promising fail because they suffer from a confusion between promise-making and promise-keeping. Philosophers have wrongly supposed that obligations to keep promises are dependent upon, or derivable from, the quality of the promises themselves, at the time they are made, instead of focusing on conditions that must be satisfied at the time when promises are supposed to be kept. It is not the quality of a promise that determines an obligation to keep it but the rightness or wrongness of performing the promised act.  相似文献   
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OBJECTIVE: This report reviews the evidence that informs the role of health and mental health care providers in addressing youth smoking cessation. DESIGN: Qualitative literature review. RESULTS: Physicians do not consistently screen adolescents for tobacco use and fail to provide recommended cessation advice. Challenges to addressing smoking cessation include the need for procedures to ensure confidentiality and the existence of competing demands to provide other services. Few published studies have specifically addressed the effectiveness of clinical interventions. Interventions that require return visits or follow-up phone contacts are technically difficult to implement in this population. Successful interventions may require resources not available in nonresearch settings. Most studies have used brief clinical intervention as a control condition, making it impossible to evaluate its effectiveness. CONCLUSION: There is little evidence that supports current clinical smoking cessation guidelines for adolescents. More research is needed to develop inexpensive, efficient clinical interventions that can provide youths access to smoking cessation help. Future challenges include reorganizing clinical systems to offer greater counseling by support staff or in electronic formats and to provide effective booster messages and follow-up care in a population that is difficult to track.  相似文献   
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This study addresses the demands of alternating bimanual syncopation, a coordination mode in which the two hands move in alternation while tapping in antiphase with a metronomic tone sequence. Musically trained participants were required to engage in alternating bimanual syncopation and five other coordination modes: unimanual syncopation where taps are made (with the left or right hand) after every tone; unimanual syncopation where taps are made after every other tone; bimanual synchronization with alternating hands; unimanual synchronized tapping with every tone; and unimanual tapping with every other tone. Variability in tap timing was greatest overall for alternating bimanual syncopation, indicating that it is the most difficult. This appears to be due to instability arising from the simultaneous presence of two levels of antiphase coordination (one between the pacing sequence and the hands, the other between the two hands) rather than factors relating to movement frequency or dexterity limits of the nonpreferred hand.  相似文献   
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Feminist theory holds that many of the pathological behaviors observed in patients result from their position in the social hierarchy. The goals of the demonstration detailed in this article are to show the impact of current gender roles on the psychological well-being of women and men and to generate understanding and discussion of the problems that relative status can create in the therapeutic relationship. This teaching demonstration draws parallels between the Zimbardo (1971) prison experiment and the impact that assignment to low-and high-power roles can have on the psychological health of women and men. Students are asked to rate men and women on some of the diagnostic criteria that the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) associates with Axis I and II diagnoses. The students watch a video of Zimbardo's prison study and then rate the prisoners and guards. This demonstration provides another explanation for gender patterns in psychopathology by demonstrating that psychologically healthy White males will develop different patterns of psychopathology depending on whether they are placed in a dominant or subordinate role. When placed in the subordinate role, they exhibit behaviors typically seen in women clients; when placed in a dominant role they exhibit behaviors commonly associated with male clients. This exercise demonstrates the unhealthy nature of the gender roles for both women and men.  相似文献   
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