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This pilot study is the first formal exploration of the concept of “Organizational Professionalism” (OP) among health system leaders in high-performing healthcare organizations. Semi-structured key informant interviews with 23 leaders from 8 healthcare organizations that were recipients of the Malcolm Baldrige National Quality Award (MBNQA) or Baldrige-based state quality award programs explored conceptualization, operationalization, and measurement of OP. Further exploration and understanding of OP in healthcare organizations has the potential to establish and sustain professional and ethical organizational cultures that bolster (...) trust through the sound implementation of laws, policies, and procedures to support the delivery of high-quality patient care. (shrink)

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In this paper, Sherrill Grace, Findley’s biographer, will examine her biographical practices in the context of Findley’s own memoir, Inside Memory, and his interest in creating fictional auto/biographers and auto/biography in several of his major novels. His fictional auto/biographers often use the same categories of document that Findley himself used—journals, diaries, archives—and this reality produces some fascinating challenges for a Findley biographer, not least the difficulty of separating fact from fiction, or, as Mauberley says in Famous Last Words, truth from (...) lies. Like many writers, Findley kept journals all his life, and they are a key source of information for his biographer; however, his way of recording information and his creation of fictional journals means that a biographer must tread carefully. While not a theoretical study of auto/biography, in this paper Grace will offer insights into the traps that lie in waiting for a biographer, especially when dealing with a biographee who is as self-conscious an auto/biographer as Findley. (shrink)

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In societies divided on ethnic and religious lines, problems of democracy are magnified – particularly where groups are mobilized into parties. With the principle of majority rule, minorities should be less willing to endorse democratic institutions where their parties persistently lose elections. While such problems should also hamper transitions to democracy, several diverse Eastern European states have formed democracies even under these conditions. In this book, Sherrill Stroschein argues that sustained protest and contention by ethnic Hungarians in Romania and Slovakia (...) brought concessions on policies that they could not achieve through the ballot box, in contrast to Transcarpathia, Ukraine. In Romania and Slovakia, contention during the 1990s made each group accustomed to each other's claims and aware of the degree to which each could push its own. Ethnic contention became a de facto deliberative process that fostered a moderation of group stances, allowing democratic consolidation to slowly and organically take root. (shrink)

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Research on the intersection of race and gender suggests that, for African Americans, racial inequality is more salient than gender inequality. However, theoretical perspectives on the multiplicative effects of status positions and “outsider within” models suggest that minority group membership can be a catalyst for the development of feminist attitudes. This article examines three issues central to feminism: recognition and critique of gender inequality, egalitarian gender roles, and political activism for the rights of women. The authors found that support for (...) feminist ideology was common for both African American women and men, although the level of support varied depending on the issue and by gender. Factors predicting the endorsement of feminist ideology also varied depending on the issue and by gender. The authors found partial support for the race saliency hypothesis, but there was also evidence of the multiplicative effects of status positions on African Americans' feminist attitudes. (shrink)

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The prevalent theories of metaphor in the literature, with very few exceptions, involve a conversion of either meaning or reference from the literal meaning or reference of the metaphor to either a corresponding simile or to a metaphorical meaning or reference. In this essay an altemative to the conversion view - i.e., a constancy theory - is offered that requires no such conversions. H.R Grice's notions of conversational maximes and implicatures provide a conceptual framework within which to account for metaphors (...) in a totally literal context. A selection procedure is suggested as the mechanism by which one can interpret metaphors and distinguish them from other figures of speech. (shrink)

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Metaphor, I argue, is a type of expression that is used to communicate information beyond that communicated by its literal meaning. I argue that the literal meaning of metaphors are essential. I attempt to account for metaphor in such a way as to retain the literal meaning, while also accounting for what is called the "metaphorical meaning" of metaphors. Secondly, I am concerned with the mechanisms in virtue of which we are able to distinguish the metaphorical from the literal. ;Chapter (...) I is a discussion of the problems that I will consider in the dissertation. These include distinguishing metaphorical from literal expressions, Donald Davidson's learnability and scrutability criteria, the exclusionary criteria, conversion and constancy theories of metaphor, and truth-values of metaphors. ;Chapter II critically examines Aristotle's, Max Black's, and Monroe C. Beardsley's intensional conversion theories. Here I argue that conversion theories are inadequate and unnecessary to account for metaphorical attributions. ;Chapter III critically examines extensional conversion theories of metaphor including Nelson Goodman's version. I discuss the difficulties that arise in postulating such reference conversions. I argue that this type of conversion theory is also unsuccessful and unnecessary. ;Chapter IV is a critical examination of four types of emotive theory of metaphor, one of which is Max Rieser's. These theories maintain, and I deny, that metaphors have an "emotive meaning" in addition to or instead of their literal meaning. I consider the shortcomings and consequences of emotive views, and argue that the postulation of emotive meanings is also misguided and unnecessary. ;Chapter V offers an alternative to conversion theories. Here I argue for a theory requiring no meaning or reference conversions. My view involves H. P. Grice's notions of conversational maxims and implicatures. I conclude that metaphors retain their literal meaning, partly in virtue of which they generate implicatures. I also conclude that our recognition of, and ability to distinguish, metaphors from literal expressions involves the violations of conversational maxims. (shrink)

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The introduction of nurse‐led telephone helplines for patients to have access to information and advice has led to the development of a new kind of practise for nurses. This study focuses on the ways NHS Direct (NHSD) nurses construct a nursing identity and shape their work in a call‐centre environment. The empirical findings are drawn from a study investigating the impact of NHSD on professional nursing issues that was part of a wider evaluation of the service in South Wales, UK. (...) Data were gathered from responses to free text questions included in a questionnaire sent to nurses in three NHSD sites. Further data were collected from focus groups held with NHSD nurses. The nurses defend their identity as nurses rather than call‐centre workers. The discourses of the nurses show a strong alignment with the traditional values of nursing, encompassing holistic and empathetic practise that has moved with the nurses across locales. We argue that the nurses frame a nursing identity in NHSD around the importance of previous experience and claim to practise holistic nursing. However, the development of new skills and adaptation of old skills in response to the demand of NHSD work challenges normative notions of traditional ‘hands‐on’ models of practise and indicates a possible movement towards a cognitive model of nursing based upon knowledge, analytical and communication skills that reflects the transformative and dynamic nature of professional identity and boundaries. (shrink)

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The development of AAC technologies is of critical importance to the many people who are unable to speak intelligibly due to a communication disorder, and to their many everyday interlocutors. Advances in digital technologies have revolutionized AAC, leading to devices that can “speak for” such individuals as aptly as it is illustrated in the case of the world famous physicist, Stephen Hawking. However, given their dependence on prefabricated language, current AAC devices are very limited in their ability to mediate everyday (...) interactions. We argue here that the limits of AAC are firstly theoretical — grounded in prosthetic models that imagine AAC devices as replacements for damaged body parts and in transmission models of language production as communication. In contrast, our multidisciplinary team aims to design pseudo-intelligent mediators of communication by blending strengths of human mediators with features of current AAC technologies. To inform the design process, we report here our initial situated studies focusing on the distributed nature of everyday communicative activities conducted with potential AAC/PIM users. Our analysis focuses on the discursive alignments of these participants and their interlocutors, attending especially to the various ways their personal aides function as human mediators. Specifically, we focus on mapping the communicative activity around each of these differently-abled individuals as they navigated a university campus. We profile the everyday interactional patterns within functional systems and across settings, and present close discourse analysis of one interaction to highlight the diverse roles personal aides adopted in mediating communication. Finally, we argue that attending to differently “abled” bodies as they move through everyday communicative environments pushes CHAT to more fully theorize physicality, individual mobilities, and the roles of bodies in the laminated assemblage of functional systems. (shrink)

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