用镜头去援助

Cristina Mittermeier的文字充满了诗意,然而镜头中却是深深的忧虑。她决心投入自己毕生的精力去保护地球上的自然资源之后,很快就意识到,用吸引眼球的图片比仅仅用科学更能有效应对环境所面临的挑战。关键的问题在于,对于自然保护摄影来说,使命感比技术更加重要。不仅要拍出经得起时间考验的照片,更要拍出能让自然界本身恒久存在下去的照片。这就是难度所在。她在雨林中的经历,完全可以写成一篇感人的小说,但是镜头说出了更为直接．更为强有力的故事,让人在感叹之余,想到了个体的生命和自然的家园那些无法割舍的关联,就像在都市的阳台上,可以看得见的亚马逊热带雨林。作为国际保护摄影师联盟的主席的Cristina Mittermeier,她所做的工作意义非凡,她正带动更多的人,从都市的阳台上走下来,走入亚马逊热带雨林,将人类忧虑的目光,一点点变成可以奶切实实拥抱的关爱。[编者按]     

Administrative gatekeeping - a third way between unrestricted patient advocacy and bedside rationing

The inevitable need for rationing of healthcare has apparently presented the medical profession with the dilemma of choosing the lesser of two evils. Physicians appear to be obliged to adopt either an implausible version of traditional professional ethics or an equally problematic ethics of bedside rationing. The former requires unrestricted advocacy of patients but prompts distrust, moral hazard and unfairness. The latter commits physicians to rationing at the bedside; but it is bound to introduce unfair inequalities among patients and lack of political accountability towards citizens. In this paper I shall argue that this dilemma is false, since a third intermediate alternative exists. This alternative, which I term 'administrative gatekeeping', makes it possible for physicians to be involved in rationing while at the same time being genuine advocates of their patients. According to this ideal, physicians are required to follow fair rules of rationing adopted at higher organizational levels within healthcare systems. At the same time, however, they are prohibited from including considerations of cost in their clinical decisions.     

Amphioxus: how to become a vertebrate

Evo-devo is a young disciplin, which aims to explain the morphological evolution of organisms through developmental mechanisms and genes networks. A major question within this discipline is the origin of vertebrates. It seems now admitted that vertebrates derive from an invertebrate chordate ancestor. Several models among living chordate representatives are used today to answer this question. The small world of evo-evo interested in the emergence of vertebrates is ebullient about the advent of several totally sequenced genomes allowing comparative analyses to become evermore reliable. Furthermore "non classical" models are developed which can be submitted to refined developmental analysis. One of these is amphioxus (genus Branchyostoma), "a peaceful anchory fillet to illuminate chordate evolution" (Garcia-Fernandez, 2006a, b). The features of this model are described in this review.     

Using Realistic Evaluation to understand how interventions work on dairy farms

Interventions that aim to help farmers change on-farm practices recommend that advisors communicate effectively with farmers, work collaboratively to set goals and provide farmers with resources that are applicable to the farm context. We developed an intervention that aimed to help farmers modify and use a standard operating procedure (SOP) for colostrum management; failure of passive transfer of immunoglobulins is common on dairy farms and SOPs for colostrum management are increasingly required by farm animal welfare assurance programs. We used Realistic Evaluation to evaluate whether, how and why our intervention to help farmers modify and use SOPs for colostrum management facilitated change and provide recommendations based on our approach that can improve the design and implementation of future interventions. We used a multiple case study on five farms over 8 months, collecting data through interviews, participant observation, document analysis and field notes. We identified three mechanisms that influenced whether participants modified and used their SOP. The purpose mechanism distinguished between participants who thought the aim of the SOP was for farm staff to learn and understand how to complete a task versus those who thought that the SOP was only useful for compliance with assurance programs. The utility mechanism distinguished between participants who thought that the SOP would be helpful for daily use on their farm, versus those who did not. The physical text mechanism distinguished between participants who used the templates we provided to modify and use their SOP, versus those who did not. A key contextual factor on all farms was participant belief of having capable and engaged staff on their farm; modification and use of the SOP did not occur unless this was the case. To facilitate change, intervention developers should actively participate in the intervention to develop an understanding of farmer needs, understand the purpose behind different goals set by farmers and integrate tools, advice and resource demonstrations when possible. We conclude that Realistic Evaluation is a useful framework for evaluating how contexts and mechanisms generate outcomes on farms, and to understand how, and in which contexts, complex interventions facilitate change. We suggest that this approach can improve the success of interventions and help direct the approaches used on different farms.     

Giving a Voice to Gambling Addiction: Analysis of Personal Narratives

Culture, Medicine, and Psychiatry - Gambling addiction (GA) is now considered a worldwide health issue. Although the topic of disorder awareness is a central issue in clinical practice, there are...