20世纪全球卫生发展的回顾与展望

20世纪人类的健康状况发生了革命性的转变,同时也面临着前所未有的挑战。疾病谱的改变及人口寿命的延长以及医疗费用的上涨仍然是困扰各国决策者的难题,卫生发展与改革任重道远。完善健康保障体系最理想的选择方案是政府为居民“购买”基本卫生服务,由国家财政和居民共同承担保险基金,普及初级卫生保健,鼓励多种形式办医,WHO确定的卫生工作目标是各成员国卫生系统改革与发展的指导方针。     

Helping or Hovering? The Effects of Helicopter Parenting on College Students’ Well-Being

Parental involvement is related to many positive child outcomes, but if not developmentally appropriate, it can be associated with higher levels of child anxiety and depression. Few studies have examined the effects of over-controlling parenting, or “helicopter parenting,” in college students. Some studies have found that college students of over-controlling parents report feeling less satisfied with family life and have lower levels of psychological well-being. This study examined self-determination theory as the potential underlying mechanism explaining this relationship. College students (N = 297) completed measures of helicopter parenting, autonomy supportive parenting, depression, anxiety, satisfaction with life, and basic psychological needs satisfaction. Students who reported having over-controlling parents reported significantly higher levels of depression and less satisfaction with life. Furthermore, the negative effects of helicopter parenting on college students’ well-being were largely explained by the perceived violation of students’ basic psychological needs for autonomy and competence.     

The Relationship Between Size of Living Space and Subjective Well-Being

Against a background of shrinking new homes and forebodings of “rabbit hutch Britain”, the relationship between size of living space and subjective well-being has never been more topical in the UK. Using the British Household Panel Survey (BHPS) and fixed effects regressions, this paper is the first to examine this relationship comprehensively. Two pathways are proposed between space and subjective well-being. First, space facilitates values and activities. Second, space signals wealth which in turn influences social status. It is proposed that wealth is a more important determinant of status for men than women, and that pathway two is therefore gendered. Part one of the paper examines the effect of a change in number of rooms per person on housing satisfaction and subjective well-being in the BHPS as a whole. Despite having a similar effect on the housing satisfaction of both genders, an increase in living space has only a (weak) positive linear effect on the life satisfaction and mental health of men. This suggests that space affects subjective well-being through pathway two, status. Part two of the paper tracks the housing satisfaction and subjective well-being over time of those individuals who move for “larger accommodation”. Consistent with various theories of adaptation, housing satisfaction increases in the year of the move; then decreases slightly before levelling out. Moving for “larger accommodation” has no positive impact on subjective well-being. Overall the results imply a weak positive relationship between size of living space and subjective well-being, but only for men.     

Resources,life events,and changes in psychological states: A prospective framework

As researchers, we are intrigued by the complexities and questions involved in the study of resources and life events. As community psychologists, we hope this framework will contribute to improving the well-being of human groups. We believe that knowing those resources most likely to be effective in buffering or boosting a particular event should guide the planning of programs for groups likely to experience that event. Moreover, it is hoped that this framework will promote the idea that resources may “boost” positive experiences, thus increasing the likelihood of growth. The promotion of positive health has long been a value in community psychology but has been difficult to actualize. The boosting of desirable events may be one step in that direction.     

Happily Stressed: The Complexity of Well-Being in Midlife

Previous studies provided mixed findings of well-being in midlife, so the present study sought to add new dimensions to this area of research by investigating diverse aspects of midlife well-being, including sources of enjoyment and stress. In a national sample of 834 Americans ages 40–60, overall well-being was high, and most participants agreed that their current time of life is “fun and exciting” (71%), a time of freedom (71%), and a time when “anything is possible” (77%). They also regarded themselves as being in a time of life for focusing on themselves (56%) and “finding out who I really am” (55%). However, 65% assessed this time of their lives as stressful (65%), and many agreed that they often feel anxious (39%), depressed (25%), or that “my life is not going well” (27%). Regression analyses revealed no notable variations in well-being by gender, ethnicity, educational attainment, work status, or relationship status. In sum, among Americans in midlife, well-being is generally high even as it coexists with stress and other mental health challenges.     

Exiters of religious fundamentalism: reconstruction of social support and relationships related to well-being

ABSTRACT

Over the past decade, researchers have documented the steady growth of religious “exiters” – those who drop their affiliation with any organised religion. Religious disaffiliation or “exiting” may affect health, and while most studies of religion and health are quantitative and emphasise the health benefits of religious involvement, little qualitative research has been devoted to documenting the lived experience of religious exiting. This qualitative study investigates the social psychological consequences of leaving religion in an understudied subgroup of exiters – individuals who have left Christian fundamentalist religions. Drawing on 24 in-depth interviews, this research reveals the processes through which former religious participants reconstruct supportive social relationships to reinforce their well-being. The results demonstrate that while it is challenging in the initial stages of the exiting process to forge and cultivate new supportive relationships, the construction of nonreligious social networks eventually contributed to their greater well-being.     

The Gold of One’s Ring is Not Far More Precious than the Gold of One’s Heart: Reported Life Satisfaction Among Married and Cohabitating South African Adults

This paper tests for differences in reported life satisfaction between married and cohabiting persons, i.e. the cohabitation gap, and in particular whether selection factors can explain the cohabitation gap. The paper also explores whether age at marriage and at start of cohabitation as well as the duration of relationship type matters for subjective well-being. Based on statistical and regression analysis of the 2008 National Income Dynamics Survey, married and cohabiting persons exhibit some differences in their respective determinants of life satisfaction. While the age at relationship commencement has no relationship with well-being, there is evidence to suggest that married people become more satisfied at a later stage in marriage, while cohabitants are more satisfied initially. A significant cohabitation gap exists (0.251), but after controlling for various selection factors, the cohabitation gap virtually disappears (0.042) and becomes insignificant, which suggests that marriage and cohabitation are very similar in South Africa. Relative income, absolute income, and education explain the largest part of the cohabitation gap. Against the global backdrop of an increasing trend towards cohabitation and declining marriage rates, the overall results of this paper suggest that, since a cohabitation gap no longer exists after controlling for selection factors, South Africans may as well not go the “official route” of entering into marriage, as cohabitation provides similar benefits in terms of its contribution to individual satisfaction with life.     

The role of community context and psychological well-being for physical health: A dyadic study of military couples

Drawing from the social organizational theory of community action and change (SOAC) within a systemic biopsychosocial perspective, associations between community context (military community connections and satisfaction with military life), psychological well-being (depressive symptoms, anxiety, and self-efficacy), and physical health were examined for a sample of active duty service members and their civilian spouses (N = 236 couples) using an actor partner interdependence framework. Service members with higher levels of military community connections reported better psychological well-being. When civilian spouses were more satisfied with military life, both partners reported better psychological well-being. In turn, both spouses’ psychological well-being was related to their own reports of physical health. Statistically significant indirect effects were found between community contexts and spouses’ physical health. Enhancing community connections may be an important leverage point for supporting health and family readiness.     

Well-Being, Quality of Life, and the Naïve Pursuit of Happiness

The pursuit of happiness is a long-enshrined tradition that has recently become the cornerstone of the American Positive Psychology movement. However, “happiness” is an over-worked and ambiguous word, which, it is argued, should be restricted and only used as the label for a brief emotional state that typically lasts a few seconds or minutes. The corollary proposal for positive psychology is that optimism is a preferable stance over pessimism or realism. Examples are presented both from psychology and economics that illustrate the dangers of optimism, and in which better outcomes can occur with a pessimistic stance. A more sophisticated approach is then presented in which, in relation to well-being and quality of life, neither optimism nor pessimism is seen as inherently better than the other, but, rather, in which psychological flexibility may contribute optimally to health and well-being.     

The Needle in the Haystack

Summary

Despite the significant damages in sexual abuse cases, the plaintiff's ability to collect the money awarded in settlement or judgment is often precluded by the limited financial resources of the defendant(s). In this chapter, practicing attorney Julian Hubbard introduces the basics of individual and corporate insurance coverage and reviews the development of very limited coverage in sexual abuse cases in statutory and case law. While direct coverage for sexual abuse injuries is as rare as a “needle in a haystack,” indirect coverage can be found in some cases, especially those in which the acts of negligent individuals other than the perpetrator facilitated the abuse and thus the plaintiff's injuries. After an overview of relevant insurance issues and law, Mr. Hubbard delineates a practical model for research and legal strategies to ensure reaching any available insurance coverage, and explores the benefits and drawbacks of drawing on administrative resources to help pay for survivors' medical and mental health care.     

Honesty–Humility and the HEXACO Structure of Religiosity and Well-Being

Past research has shown that general and intrinsic religiosity is related to higher Big Five Agreeableness, Conscientiousness and, to some extent, Extraversion. With the rise of the six-factor HEXACO (Honesty–Humility, Emotionality, eXtraversion, Agreeableness, Conscientiousness, Openness) model of personality, however, a more differentiated look at religiousness and personality is called for. It has been suggested that religiosity is more associated with Honesty–Humility than with Agreeableness. The new personality factor, Honesty–Humility has also been shown to have null or weak relations with happiness. In 5 studies involving 1375 participants from Iran, Poland, and Malaysia, the relations of Honesty–Humility and other HEXACO dimensions to religious orientation and well-being outcomes were investigated. As expected, Honesty–Humility was one of the strongest personality correlate of religiosity. Higher scores on religiousness were also associated with Agreeableness, Conscientiousness, and to some extent, Extraversion showing that the main personality characteristics of religiosity are consistent across religious contexts and personality models. Relations of Honesty–Humility to psychological well-being scales were consistently positive and stronger than its relations to subjective well-being measures, suggesting that Honesty–Humility may not be “bad” for pleasure attainment and pain avoidance, but it is definitely “good” for living a virtuous, fully functioning life.     

The Priority of “Liberty” or “Ping An ”: Two Different Cultural Value Priorities and Their Impacts

“Liberty” is a core, prior value of modern Western culture, and particularly of Anglo-American political and economic discourse. For more than a century, the US and other Western countries have been doing their utmost to promote the value of liberty around the world. However, different nations and cultures have different value priorities. Considering “liberty” as the essential, unassailable prior value is an Anglo-American cultural particularity without universal applicability. In China, “liberty” as a high value is a new idea imported from the West at the beginning of the modern era which never enjoyed a very important position in ancient China. Generally speaking, in Chinese culture, the value of “ping an,” with its connotations of peace, safety, equality, health, harmony, and tranquility, is obviously a prior value. Different value priorities have different impacts on culture. This paper tries to compare the American value priority of “liberty” with the Chinese value priority of “ping an,” while discussing their different historical backgrounds and cultural impacts. It argues that values and value priorities are neither absolute nor universal, but that they are rather historical, situational, and dynamic. Value priority in a society should be based on that society’s particular social reality and on the stage of development and the life requirements of its people, rather than on an outside imperative. In the era of globalization, different and even sometimes contradictory human values may actually mutually complement and counterbalance one another.     

Yoga-integrated psychotherapy for emotion dysregulation: A pilot study

Aims & Objectives

Yoga has been evidenced as beneficial for physical and mental health. This study sought to pilot the acceptability and feasibility of a yoga-integrated psychotherapy (YiP) intervention, aimed at alleviating difficulties in emotion regulation. A further aim was to explore the perceived effectiveness of YiP in alleviating depression, anxiety and improving well-being.

Methods

Seven participants who scored significantly on the Difficulties in Emotion Dysregulation Scale (DERS) took part in a psychological assessment session followed by six weekly one hr therapy sessions. Participants completed self-report measures in each session to quantify the effects of each YiP session on emotion regulation, well-being, depression and anxiety. Following seven sessions, five participants completed qualitative follow-up interviews to explore subjective experiences of YiP and any perceived impacts.

Findings

An ANOVA that contained data from seven participants who completed all six sessions revealed that DERS scores were significantly lower, and well-being scores were significantly higher, at both mid and end-points than at baseline. Thematic analysis of qualitative interviews identified five themes: “YiP assists the client's psychological and emotional processing,” “YiP improves insight and focus,” “YiP is culturally sensitive,” “the body facilitates regulation and resilience” and “YiP is acceptable & impactful.”

Conclusion

The study presents promising findings for the integration of yoga into psychotherapeutic practice and indicates that YiP may have beneficial effects on emotion regulation and psychological well-being. Future research should use randomised controlled methodologies to examine the ability of YiP to alleviate a wide range of affective symptoms using a larger sample of participants.     

Health, Well-being and Beauty in Medicine

This paper aims at explicating the role of the connections and interactions between health, well being and beauty. The primary goal of all medical approaches, including the classic biomedical and humanistic or humane approaches, is to restore or create health, whereby medical approaches that include prevention go beyond the mere restoration of health to include the preservation of health. Equating well-being and thus health with a largely self-determined and joyful life, then not only does a healthy life become a beautiful life, a beautiful life also becomes a healthy life! By bringing Beauty into the health discourse, we are entering the field of aesthetics in general and social aesthetics in particular. As the beautiful is not just a decorative element of life but a genuine source of human strength, it gives us the strength and power we need to implement and achieve all that we then experience as “well-being” and that is called a healthy life. Therefore a further development of a human-based medicine is needed, a medicine that focuses not on a disease construct but which places a human being as a whole, with all his potential and limitations at the heart of diagnostic and therapeutic efforts. The noblest therapeutic goal of this kind of medicine can only be the restoration or preservation of a comprehensive state of health in the sense of complete physical, mental and social well-being, in the sense of opening up the possibility for a mostly autonomous and joyful life.     

Interpretation of Poverty in St. Louis County,Minnesota

The paper analyzes subjective poverty in St. Louis County, Minnesota with the methods of systematic data collection. The initial hypothesis states that American people blame the individuals for their poor living conditions. Based on the Easterlin paradox, the next hypothesis states that subjective and absolute poverty lines are independent. Taking into account that the USA is a developed country, subjective wellbeing is supposed to be associated with relative deprivation. The paper concludes that the items most related to poverty are “no job”, “no access to basic needs” and “addiction”. The main causes of poverty are “cycle of poverty”, “no job” and “addiction”. The main consequences of poverty are “no access to basic needs”, “poor health” and “minimum education”. The results revealed that the most important items related to poverty and the main causes and consequences of poverty cannot be classified unambiguously as being individualist, structural or fatal. The analysis showed that subjective poverty line is different from the objective lines. This result supports the Easterlin paradox and implies that people can be dissatisfied with their lives even when they are above the poverty line according to the official statistics. Elimination of absolute poverty may therefore not be enough to improve subjective well-being. The evidence that relative income assessment is not correlated with subjective well-being implies that people are not concerned with their relative income position.     

Occupationally Embedded Exercise Versus Rote Exercise and Psychosocial Response in College-Aged Females

Community integration through occupational engagement is an integral tenet of occupational therapy. However, little is known about how pets may assist this process. This study explores community integration through pet ownership as a meaningful, lifelong, occupation for one person with bipolar illness receiving Assertive Community Treatment. Using a case study approach, eight qualitative interviews, as well as observation and analysis of pet photos, were conducted with the mental health consumer and also with members of her social network. Data were analyzed inductively according to the constant comparative approach. The findings reveal that pet ownership assisted the person to counterbalance and move beyond stigma through pets as enablers of: “continuity,” “belonging,” “action and self-construction,” “acceptance,” and “participation.” This process was influenced by the “severity of illness,” “view of community,” and “supports and resources.” The results contribute to our understanding of pet ownership as a means to community integration. The study indicates that to enable persons with a mental illness to engage in pet ownership, occupational scientists need to examine and understand this occupation in the broader context of recovery, health, and well-being. A perspective of pet ownership as meaningful occupation challenges occupational therapists to develop strategies to actively engage clients and their pets in their community.     

The CODE: A revised battery for coping and defense and its relations to subjective health

A condensed test battery (the CODE) based on the Utrecht Coping List (UCL) and part of the Defense Mechanisms Inventory (DMI) has been developed to assess coping and defense in large population studies. It was tested for reliability and validity in students and back pain patients. Principal components factor analysis of the subscales of the UCL and DMI in the student sample revealed two coping clusters: “Instrumental mastery-oriented coping” and “Emotion-focused coping” and two defensive clusters: “Cognitive defense” and “Defensive hostility”. “Instrumental mastery-oriented coping” was negatively related to subjective health complaints measured with Ursins Health Inventory (UHI). The back pain patients were clearly different from the students, using less coping and more defensive strategies. They had more subjective health complaints that showed negative correlations with “Instrumental mastery-oriented coping”. The CODE is a comprehensive battery that may be valid for large population studies of psychological determinants of muscle pain and other subjective health problems.     

We Can Make It Better: “We” Moderates the Relationship Between a Compromising Style in Interpersonal Conflict and Well-Being

Compromising is considered a useful strategy for solving interpersonal conflicts. However, compromising, which includes accommodating and sacrificing, may also lead to anxiety and depression. Therefore, the current study focused on a moderating mechanism between compromising and psychological health. Based on self-expansion theory, we hypothesized that the more individuals have a relational focus (i.e., a greater use of “we”) while narrating their compromising experiences, the better psychological health they will experience. Two hundred sixty-one participants from National Taiwan University (mean age = 20.40, 53.26 % male, 46.74 % female), wrote about an experience of conflict with their parents and completed a package of questionnaires to measure their conflict management style and psychological health. The frequency of the “we” pronoun was considered an index of relational focus. As predicted, the results from a hierarchical multiple regression demonstrated that “we” moderated the effect of compromising style on well-being. Specifically, the relationship between compromising and psychological well-being were strengthened for individuals who had more relational focus. Thus, although a compromising style helps solve interpersonal conflicts, it does not necessarily increase individuals’ well-being. How individuals anchor their experiences are more important.