Increasingly distant from life: problem setting in the organization of home care

Abstract The analysis undertaken in this paper explores the significance of a central finding from a recent field study of home care case management practice: a notable feature of case management work is the preparation of an orderly, ordered space where care may be offered. However, out of their encounters with an almost endless variety of situations, out of people's diverse narratives of need, case managers seem able to pick out only limited range of recognized needs to which to respond and demonstrate a series of responses themselves equally limited. Though this observation suggests a kind of efficiency that is currently highly valued within healthcare systems, it also underlines the system's inability to engage difference and variability in a meaningful way. This inability or limitation in effectively engaging difference is conceptualized here as, in some sense, a problem, and the nature of this problem is explored through the rhetorical process of problem setting. The central question becomes how might we develop and deploy an orderly and coherent system of care without essentializing people's experiences, without treating these experiences reductively, without, in a Foucaultian frame of reference, allowing what can be understood as similarity or resemblance among clients and situations to be folded back into sameness? As we encounter complexity, variability and difference in practice, how should we treat it?     

老子思想与图书馆建设

老子作为有史以来最早的“图书馆馆长”,其思想籍著《道德经》对华夏民族产生了巨大的影响,也在无影无形之中影响着图书馆的生存方式,所创造的道德文化对图书馆建设有着深刻的启迪。     

传染病防治的伦理对策

人为因素是传染病发生和传播的重要原因,所以传染病的防治离不开对人的社会行为的伦理矫正。我们要通过落实系统的传染病防治的伦理对策,促使人们接受可持续发展的伦理观,追求健康的生活方式,实现公正的卫生保健,达到有效遏制传染病,保障人民健康的目的。     

Ethical and Practical Considerations for Collecting Research-Related Data from Commercially Sexually Exploited Children

This article presents seven challenges of collecting primary (i.e., firsthand) data from commercially sexually exploited children (CSEC). We drew on our research team's experience collecting longitudinal data from 28 CSEC survivors with a 12-month follow-up period. We used both face-to-face and electronic group brainstorming methods to nominate a list of research-related challenges. The two main themes that were identified were challenges that can limit data quality and concerns about the impact of research on participants, researchers, and others. The three challenges related to data quality are (1) the age of the research participants; (2) questions about obtaining informed consent from parents or guardians; and (3) the over-interrogation of CSEC youth. The four challenges related to concerns about the impact of research were (4) concerns that research participation may further exploit youth; (5) staying in the role of researcher and refraining from providing advocacy; (6) secondary trauma and burnout experienced by research staff; and (7) the additional burden that research and data collection may place on the advocates and direct service providers. Because the process of collecting data from CSEC youth can be complicated, and rife with ethical and practical challenges, we have relayed our experiences with seven specific research-related challenges in order to stimulate discourse and further progress in the field.     

Case of Justified Therapeutic Placebo Use

Placebos are substances or interventions that have no known intrinsic value in treating the condition for which they are given (Beauchamp & Childress, 1994). In research, the placebo effect is a well-described nuisance variable that researchers attempt to control through research design. In therapeutic management, particularly in nursing, placebo use is almost universally condemned as a deceptive practice (Bandman & Bandman, 1995; Fox, 1994).