社区卫生服务机构实施品牌战略的构想

"看病难"、"看病贵"两大问题,阻碍和谐社会建设、影响人民群众生命健康。大力发展社区卫生服务,将成为在城市缓解老百姓"看病难"、"看病贵"问题的重要举措,但由于种种问题与困难,降低了老百姓对它的信任度。在社区卫生服务机构实施品牌战略,塑造品牌形象,无疑是提升老百姓信任度的一剂良方,社区卫生服务必将迎来飞速发展。     

The ethics of complexity and the complexity of ethics

Abstract

In this paper, we investigate the implications that a general view of complexity - i.e. the view that complex phenomena are irreducible - hold for our understanding of ethics. In this view, ethics should be conceived of as constitutive of knowledge and identity, rather than as a normative system that dictates right action. Using this understanding, we elaborate on the ethics of complexity and the complexity of ethics. Whilst the former concerns the nature and the status of our modelling choices, the latter denotes a contingent and recursive understanding of ethics. Although the complexity of ethics cannot be captured in a substantive normative model, we argue that this view of ethics nevertheless commits one to, what we term, ‘the provisional imperative’. Like Kant’s categorical imperative, the provisional imperative is sub-stantively-empty; however, unlike Kant’s imperative, our imperative cannot be used to generate universal ethical principles. As such, the provisional imperative simultaneously demands that we must be guided by it, whilst drawing attention to the exclusionary nature of all imperatives. We further argue that the provisional imperative urges us to adopt a certain attitude with regard to ethical decision-making, and that this attitude is supported and nurtured by provisionality, transgressivity, irony, and imagination.     

Fruitful Interchange or Polite Chitchat? The Dialogue Between Science and Theology

The demand that epistemic support be explicated as rational compulsion has consistently undermined the dialogue between theology and science. Rational compulsion entails too restrictive a form of epistemic support for most scientific theorizing, let alone interdisciplinary dialogue. This essay presents a less restrictive form of epistemic support, explicated not as rational compulsion but as explanatory power. Once this notion of epistemic support is developed, a genuinely productive interdisciplinary dialogue between theology and science becomes possible. This essay closes by sketching how the Big Bang model from cosmology and the Christian doctrine of Creation can be viewed as supporting each other.     

The Brier Rule Is not a Good Measure of Epistemic Utility (and Other Useful Facts about Epistemic Betterness)

Measures of epistemic utility are used by formal epistemologists to make determinations of epistemic betterness among cognitive states. The Brier rule is the most popular choice (by far) among formal epistemologists for such a measure. In this paper, however, we show that the Brier rule is sometimes seriously wrong about whether one cognitive state is epistemically better than another. In particular, there are cases where an agent gets evidence that definitively eliminates a false hypothesis (and the probabilities assigned to the other hypotheses stay in the same ratios), but where the Brier rule says that things have become epistemically worse. Along the way to this ‘elimination experiment’ counter-example to the Brier rule as a measure of epistemic utility, we identify several useful monotonicity principles for epistemic betterness. We also reply to several potential objections to this counter-example.     

The Irony of Social Trust: Individual‐level and Contextual‐level Links with Protest Intention and Radical Right Support in Switzerland

This research examines how social trust translates into dynamics of mobilisation for inclusion or exclusion in Swiss cantons by studying how social trust is linked to equality‐directed protest intention versus radical right support, comparing individual‐level and contextual‐level relationships. The study is based on data from the Swiss Household Panel collected between 2002 and 2008. The impact of individual‐level and contextual‐level social trust is analysed in three‐level regression models of repeated observations, nested in individuals who are nested in cantons. The results indicate complex patterns that depend on the level at which social trust is assessed and confirm the need for a contextualised view of social trust and social capital. For individuals, higher social trust is associated with higher protest intention and lower radical right support. However, in cantons characterised by higher rates of social trust, individuals are less likely to engage in protest actions and more likely to support the radical right. Further analyses show that canton‐level social trust is intertwined with other contextual factors, suggesting that in certain configurations, that is, combined with low levels of cultural and social diversity, climates of social trust may be linked to more restricted forms of solidarity and the persistence of inequality. Copyright © 2015 John Wiley & Sons, Ltd.     

The arc of the rope swing: humour,poetry, and spirituality in Charlotte’s Web by E. B. White

This essay analyzes the classic American children’s novel, Charlotte’s Web, by E.B. White, which tells of a sophisticated spider’s rescue of a piglet who is being prepared for slaughter. The ‘arc of the rope swing' refers to a rope swing enjoyed by children in the novel; it is also a metaphor for the way White holds opposing forces in tension. Most noteworthy is the tension between poetic language and humour in the novel; White uses both to convey a sense of ultimate goodness and trust-in-being. Poetic language sets a contemplative tone (‘poetic pauses’) and conveys spiritual themes, including delight, wonder at the beauty of the natural world, ‘divine discontent’ (yearning), memento mori, sorrow and hope. In contrast, White’s ‘gracious humour’ is fast-paced and entertaining; it keeps the novel from being too preachy or solemn. His humour includes 1) wordplay (including the juxtaposition of incongruous words and images; dramatic irony; and puns ), 2) comedic characters (Wilbur as lovable buffoon, Charlotte as incisive wisdom figure) and 3) satire (scorn for human gullibility, arrogance and poor treatment of animals). White sharply satirises human arrogance and demonstrates the value of humility (embodied in Charlotte and Wilbur). The article also contains brief summaries of Charlotte's Web and of White's biography, and it concludes with a substantial set of “talking points” for discussing the novel’s spiritual themes with children.     

Judging the plausibility of arguments in scientific texts: a student–scientist comparison

The ability to evaluate scientific claims and evidence is an important aspect of scientific literacy and requires various epistemic competences. Readers spontaneously validate presented information against their knowledge and beliefs but differ in their ability to strategically evaluate the soundness of informal arguments. The present research investigated how students of psychology, compared to scientists working in psychology, evaluate informal arguments. Using a think-aloud procedure, we identified the specific strategies students and scientists apply when judging the plausibility of arguments and classifying common argumentation fallacies. Results indicate that students, compared to scientists, have difficulties forming these judgements and base them on intuition and opinion rather than the internal consistency of arguments. Our findings are discussed using the mental model theory framework. Although introductory students validate scientific information against their knowledge and beliefs, their judgements are often erroneous, in part because their use of strategy is immature. Implications for systematic trainings of epistemic competences are discussed.     

Direct Democracy and Institutional Trust: Relationships and Differences Across Personality Traits

Direct democracy plays a prominent role in the explanation of institutional trust. To date, however, empirical findings on the effects of direct democracy remain inconclusive. In this article, we argue that this inconclusiveness can be partly ascribed to the diverse effects direct democracy has on individuals. In other words, direct democracy influences institutional trust, but how and to what degree depends on individuals’ personality traits. Running hierarchical analyses of unique survey data from a random sample of eligible Swiss voters, we document three findings: First, we show that the number of ballot measures is not directly associated with institutional trust. Second, we demonstrate that the Big Five personality traits affect the propensity to trust. Third, some of these traits also alter the relationship between direct democracy and institutional trust, suggesting that certain personality types are more likely to be sensitive to popular votes than others and that not everyone is equally likely to respond to political stimuli, even in highly democratic environments.     

Trust or Distrust Toward Healthcare Services: Breast Screening in the North and South of Italy

This article follows a previous study that has recently been published in Narrare I Gruppi and explored the reasons for the large numeric gap between the regions of the North and South of Italy, referring to the breast cancer screening program adherence rate sponsored by the Italian Healthcare System, that addresses all women living in Italy ranging in age between 48 and 69 years, and proposes a free mammogram every two years. The effectiveness of cancer early detections has been widely demonstrated by medical research; this kind of diagnosis is particularly important in the case of breast cancer. A diagnosis of this form of cancer at its early phases in 97% of cases allows women to survive at least five years after it. However, the different level of trust women feel for healthcare structures is the discriminating element between the North and South of Italy for their access to the screening program. This topic will be thoroughly analyzed by presenting the results of research aimed at evaluating the meaning given to the outcomes of a first exploratory study, this second study also offers the opportunity to share our results within the social context that has generated them. The outcomes of the present research have been presented to a group of “privileged witnesses” living in the South (Naples and its surroundings): 12 women aging from 49 to 65, and 5 healthcare workers (one doctor, 25 two nurses, and two Local Health Authority supervisors); they took part in three Focus Groups for an in-depth look of the theme in question. The analyses of the groups' debates, carried out by means of a software for text analysis (T-LAB), confirmed the results of the previous research: the diffidence and lack of synergy between institutions and healthcare workers are the causes of southern women's lack of participation to the breast cancer screening program. In particular, the comparison between women's and workers' viewpoints shows a different emotional connotation about the possibility to improve participation to the screening: the workers' optimism countervails women's distrust and pessimism.     

B2B commitment building in emerging markets: the case of Brazil

The research examines the suitability of relationship marketing paradigms to emerging markets (EMs) through the lens of communication, relationship benefits and commitment. Using the U.S. as a developed nation sample and Brazil as a proxy for EM countries like the BRIC nations, a B2B buyer–supplier commitment-building model is conceptualized and tested for context-specific boundaries. The study compares communication behaviors and relationship benefits along functional, psychological and social dimensions to discern the evaluation process and governance mechanisms influenced by an EM buyer’s institutional environment. Results showed that buyers from relation-based EMs like Brazil base their relationship commitment more on the psychological attributes of the partnership, while a buyer’s commitment-building process in rule-based, developed nations like the US is largely influenced by functional attributes.