Who should manage care? The case for providers

Health care professionals should be the ones to make allocation decisions in the managed care setting because they are in the best position to assess outcomes, cost effectiveness, and quality of care.     

Variation of Isometric Response Force in the Rat

Hungry, unrestrained rats (N = 7) were rewarded for pressing a response beam in excess of 11 different force requirements. Changes in peak force production as a function of peak force requirement were examined by analyses of the first four moments of distributions of peak response forces: constant error, the within-subject standard deviation, skewness, and kurtosis. Results were similar to those previously obtained with human subjects: Constant error was positive at low and negative at high force requirements, the within-subject standard deviation increased as a negatively accelerating function of force requirement, and skewness and kurtosis were positive at low force requirements and decreased to negative values at the highest increments. Additional analyses of response kinetics indicated that rats, like humans, meet increasing force requirements by altering the rate of rise of force. The performance similarities suggest that common processes are engaged by the human and rat motor control systems to solve the problem of generating forces that are appropriate to the prevailing environmental constraints.     

A classroom demonstration of self-monitoring, reactivity, and interobserver agreement

A brief classroom demonstration designed to introduce students to the concepts of self-monitoring, reactivity, and interobserver agreement is presented. The demonstration provides students with opportunities to monitor their own behavior, record the behavior of others, and calculate interobserver agreement percentages. Results of using the demonstration with students from two classes are presented.     

开放的中国──封闭的中国

禁地,亦即指由于地形原因而不可进入的地区,尤其是指出于政治、宗教或其他动机而作出的决策所禁止入内的区域（场所、城市、国家）。禁地往往蒙上了一种神秘的气氛．几乎必然会引起人们的好奇。到达拉萨曾是几代探险家的梦想。这一地区不仅对外人封闭,而且对“内部人”也封闭：任何人不得离开“外出”。德川幕府对日本实行的隔绝就是这样一种双向隔离。当然．地理条件也有助于这种隔离,因而使之轻易地付诸实行。有人指出（或许这种说法不够严肃）．举世闻名的中国长城不仅意味着防范匈奴入侵,更意味着防止中国人逃离。史料也表明中国过…     

Being skeptical about the medical humanities

In this paper the author challenges the prevailing view that contemporary writing in the medical humanities is serving the needs of the various health care disciplines. The current medical humanities literature assumes that physicians are the appropriate target group. This is most notably the case within health care ethics literature. There appears to be an unexamined assumption that physician-centric approaches to clinical ethical decision-making are the standard by which appropriate ethical practice is judged. The author challenges this assumption and addresses the problems that this approach engenders. The medical humanities literature appears to reinforce hierarchical, patriarchal arrangements which are themselves not morally neutral.     

Induced delivery of anencephalic fetuses: a response to James L. Walsh and Moira M. McQueen

James Walsh and Moira McQueen accurately conclude that the early delivery of anencephalic fetuses is morally acceptable, but the reasoning they use to reach that conclusion is flawed. First, the principle of double effect does not require a weighing of good and evil, but rather seeks a sufficient reason for tolerating the physical evil indirectly intended. Second, the principle of double effect requires a clear distinction between physical and moral causality. Third, the Catholic moral tradition will not admit direct and intended killing of the innocent. Rather, early delivery of anencephalic fetuses is permissible because of the pathology associated with delivery of anencephalic fetuses at full term. Thus, the early delivery of an anencephalic infant is acceptable if the purpose of the moral act is avoiding a pathological condition on the part of the mother.     

世界各种宗教与世界宗教

宗教非常重要 宗教关注整个生命的终极价值,是涉及人类的非常重大的事情。 宗教起团结作用 宗教起团结联合的作用,但宗教一多则起分裂作用。因为各种宗教是分裂的,这对宗教来说是有害的。 传统的区分或分割 每一传统文化均建立它关于生命本质及其价值的原则,并且传授这些原则,使之成为人们的行为规范,因为人们相信这些原则是正确的。但是早期产生的关于生命与价值的信念,缺乏足够的知识,只是因为人们信以为真而且非常重要,这些信念便被视为神圣不可侵犯,是生命不可或缺的。这些原则在孤立环境中,甚至解释力不强时,也还可能使人们获得幸福。但当人们与其他传统的原则与实践发生冲突,另一种传统威胁到他们自己传统时,每个人都相信自己的传统正确而另一种传统错误,他一定会设法反对它。