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Patients with insufficient financial resources place physicians in a conflict of interest between the patients' needs and the financial interests of the physician, other patients, and society. Not only must physicians act ethically, but they must avoid liability for violating their legal duties to their patients. The traditional rules of contract and malpractice law that govern the patient-physician relationship do not provide satisfactory guidelines. Better answers are found in the rules of fiduciary law, but only with regard to direct conflicts between patients and physicians and only at the risk of reducing patient access to care. Certain types of legislative action can resolve these conflicts by altering the traditional legal rules, but care must be taken to preserve patient-physician trust, which the legal rules were designed to enhance.  相似文献   
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Among the predominant themes in the last few years of bereavement studies have been those around disenfranchised grief, masculine grief, spirituality and grief, and the movement from medical/hierarchical models of grief work/counseling to a more non-hierarchical model that emerges internally, inherently, and intrinsically within the bereaved. In the latter model the grief counselor becomes a facilitator or, as Alan Wolfelt noted at the Chicago ADEC conference, a companioning presence. The intent of this article is to take this conversation into the realm of theology, and/or biblical theology. The following offers theological analysis of what is already good clinical theory. Integrating theories from anthropology and theology, this article will explore the concepts of voice, etic and emic theory, and incarnational theology as they relate to emerging patterns in bereavement studies. It will also relate a model of the Kingdom of God to disenfranchised grief, as well as offer support for the theory of masculine grief from biblical sources and complementary fields of study.  相似文献   
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The purpose of this study was to examine the impact of a peer-leadership training program on youth from a low-income urban school district. The methodological approach was grounded in community-based participatory research, in which a multicomponent school-based recess and physical activity program was examined. Data included 15 focus groups conducted with 77 fourth- and fifth-grade participants and semistructured interviews with 13 adult leaders. Results of a thematic content analysis suggest that decisions to join the program, role expectations, and training received impacted leadership development, personal development, and transfer of skills to other domains.  相似文献   
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This study examined how U.S., Finnish, and Irish educators identified and supported struggling readers. Using Johnston's (2011) framework for evaluating reading interventions and activity theory (Engeström, 1999), we interviewed educators in four U.S., three Irish, and three Finnish schools. In the United States, the adoption of three beliefs—reductionist reading philosophy, difficulties as cognitive and remediated through instruction, and reading problems as unexpected phenomena—reinforced a skills-driven approach. Irish and Finnish educators adopted a more holistic view of reading, and teachers used formative assessment to support struggling students over extended periods while working collaboratively with other staff. Discussion focuses on how these beliefs influenced divisions of labor, roles and responsibilities, and the urgency with which difficulties were addressed.  相似文献   
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We discuss three theoretical models from met expectations research in the fields of organizational behavior and consumer psychology. Based on the fundamental arguments in the models, we term these models: disconfirmation, ideal point, and experiences only. We present three-dimensional graphical and analytical representations of the models, with satisfaction being a function of expectations and experiences. We tested the models in the context of a new information system implementation in an organization, with expectations, experiences, and system satisfaction measured for both ease of use and usefulness, the focal constructs of the Technology Acceptance Model (TAM). We found that an experiences only model in which expectations had no measurable effect best explained the data for ease of use. The results for usefulness indicated a modified version of the experiences only model in which the positive effect of experiences becomes slightly stronger—i.e., more positive—as expectations increase.  相似文献   
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Moral relativism is an attractive position, but also one that it is difficult to formulate. In this paper, we propose an alternative way of formulating moral relativism that locates the relativity of morality in the property that makes moral claims true. Such an approach, we believe, has significant advantages over other possible ways of formulating moral relativism. We conclude by considering a few problems such a position might face.  相似文献   
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Semantic Holism is the claim that any semantic path from inferential semantics (the indeterminate semantics forced by the classical inference rules of PC) reaches all the way to classical semantics if it is even one step long. In our joint paper Semantic Holism, Belnap and I showed that some such semantic paths are two steps long, but we left open a number of questions about the lengths of semantic paths. Here I answer the most important of these questions by showing that there are infinitely long semantic paths that begin at inferential semantics but that do not even reach classical semantics. I do this by showing how to construct such an infinite semantic path from the members of the family of (n–1)-out-of-n-disjunction connectives.  相似文献   
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