Suchergebnisse

Reaching a decision about whether and when to visit the doctor can be a difficult process for the patient. An early visit may cause the doctor to wonder why the patient chose to consult when the disease was self-limiting and symptoms would have settled without medical input. A late visit may cause the doctor to express dismay that the patient waited so long before consulting. In the UK primary care context of constrained resources and government calls for cautious healthcare spending, there is all the more pressure on both doctor and patient to meet only when necessary. A tendency on the part of health professionals to judge patients' decisions to consult as appropriate or not is already described. What is less well explored is the patient's experience of such judgment. Drawing on data from 52 video-elicitation interviews conducted in the English primary care setting, the present paper examines how patients seek to legitimise their decision to consult, and their struggles in doing so. The concern over wasting the doctor's time is expressed repeatedly through patients' narratives. Referring to the sociological literature, the history of 'trivia' in defining the role of general practice is discussed, and current public discourses seeking to assist the patient in developing appropriate consulting behaviour are considered and problematised. Whilst the patient is expected to have sufficient insight to inform timely consulting behaviour, it becomes clear that any attempt on the part of doctor or patient to define legitimate help-seeking is in fact elusive. Despite this, a significant moral dimension to what is deemed appropriate consulting by doctors and patients remains. The notion of candidacy is suggested as a suitable framework and way forward for encompassing these struggles to negotiate eligibility for medical time.

The Hubbard Brook Experimental Forest (HBEF) was established in 1955 by the U.S. Department of Agriculture, Forest Service out of concerns about the effects of logging increasing flooding and erosion. To address this issue, within the HBEF hydrological and micrometeorological monitoring was initiated in small watersheds designated for harvesting experiments. The Hubbard Brook Ecosystem Study (HBES) originated in 1963, with the idea of using the small watershed approach to study element fluxes and cycling and the response of forest ecosystems to disturbances, such as forest management practices and air pollution. Early evidence of acid rain was documented at the HBEF and research by scientists at the site helped shape acid rain mitigation policies. New lines of investigation at the HBEF have built on the long legacy of watershed research resulting in a shift from comparing inputs and outputs and quantifying pools and fluxes to a more mechanistic understanding of ecosystem processes within watersheds. For example, hydropedological studies have shed light on linkages between hydrologic flow paths and soil development that provide valuable perspective for managing forests and understanding stream water quality. New high frequency in situ stream chemistry sensors are providing insights about extreme events and diurnal patterns that were indiscernible with traditional weekly sampling. Additionally, tools are being developed for visual and auditory data exploration and discovery by a broad audience. Given the unprecedented environmental change that is occurring, data from the small watersheds at the HBEF are more relevant now than ever and will continue to serve as a basis for sound environmental decision-making. ; Public domain authored by a U.S. government employee

Frontmatter -- Contents -- Illustrations -- Preface -- Introduction. Nation-States in History -- PART 1. NATIONAL IDENTITIES -- Chapter 1. Nationalism, Popular Sovereignty, and the Liberal Democratic State -- Chapter 2. What States Can Do with Nations: An Iron Law of Nationalism and Federation? -- Chapter 3. A State without a Nation? Russia after Empire -- Chapter 4. The Return of the Coercive State: Behavioral Control in Multicultural Society -- PART 2. STATE SECURITY -- Chapter 5. States, Security Function, and the New Global Forces -- Chapter 6. States and War in Africa -- PART 3. STATE AUTONOMY -- Chapter 7. National Legislatures in Common Markets: Autonomy in the European Union and Mercosur -- Chapter 8. The Tax State in the Information Age -- Chapter 9. States, Politics, and Globalization: Why Institutions Still Matter -- Chapter 10. Globalization, the State, and Industrial Relations: Common Challenges, Divergent Transitions -- PART 4. STATE CAPACITY -- Chapter 11. The State after State Socialism: Poland in Comparative Perspective -- Chapter 12. Rotten from Within: Decentralized Predation and Incapacitated State -- Conclusion. What States Can Do Now -- Contributors -- Index