The health needs of the majority versus the health needs of the individual: The reorganization of medical education in Colombia

The challenge of excellence in community health services has been taken up by medical educators in Colombia. Confronted with a nation where the primary indicators of disease mortality and morbidity (cardiovascular disease and infant mortality) were characteristic of First and Third World patterns, respectively, the Ministry of Health and La Asociacion Colombiana de Facultades de Medicina (ASCOFAME), representatives of institutions of medical education, have collaborated to conduct a needs assessment of the country's health needs and devised an implementation plan designed to better address the needs of the majority of that nation's people.As a model, the Colombian reorganization of medical education is an example which could be emulated by the U.S. where policy makers are struggling with troublesome questions of cost, equity and quality.     

Collective Trauma,Implicit Memories,the Body,and Active Imagination in Jungian Analysis1

This presentation attempts to show the healing potential underlying the inclusion of the patient's body in the analytic process, while honouring and revisiting the understanding of the psyche-body connection described by Jung in his early work. In addition, the author offers reflections on the impact of collective trauma whose aftermath, among others, has been the disappearance of thousands of people, consequently breaking the family genealogy, leaving hundreds of children stripped of their roots and true identity. Referencing clinical material, the author describes how the process of translation and integration—from the sensory-perceptual to the conceptual-symbolic—can be halted on account of collective trauma occurring at an early stage in development. Moreover, it is shown how the potential of the archetype or image schema, linked to the somatic-affective early experiences encoded as implicit memories, can be recovered, when Embodied Active Imagination is included in the analytic work. The patient's bodily gestures and somatic experience may bridge the gap between the preverbal-implicit knowledge and the emergence of emotions and images that allow for the creation of a new symbolic narrative.     

Delay reduction: current status.

Delay-reduction theory states that the effectiveness of a stimulus as a conditioned reinforcer may be predicted most accurately by the reduction in time to primary reinforcement correlated with its onset. We review support for the theory and then discuss two new types of experiments that assess it. One compares models of choice in situations wherein the less preferred outcome is made more accessible; the other investigates whether frequency of conditioned reinforcement affects choice beyond the effect exerted by frequency of primary reinforcement.     

多点触觉定位

在左手食指第一节腹侧分别进行1个点、2个点和3个点的定位实验,探讨了多点定位的特点。实验发现,按单个点的定位误差来计算．1个点和3个点的定位误差无显著差异,且二者均显著地低于2个点的定位误差;在2个点的定位中,一个点的定位误差是此2个点的空间距离的函数．定位误差有随距离加大而增加的趋势;在3个点的定位中．同一个点在不同的3点组台中的定位误差无显著差异。结果指示,多点触觉定位除以受刺激的躯体部位框架为参照（基本参照）外,还受到诸刺激点构成的刺激模式（次级参照）的影响。     

Primary health care for women: What is it and who provides it?

Recent federal policy has highlighted historically underrecognized women's health issues. Women comprise the majority of the population, especially the elderly. Women's health care needs, utilization patterns, and outcomes vary from those of men, and often among each other. Primary health care services for women are multidisciplinary and emphasize prevention, education, and early intervention as well as treatment. Psychologists and other primary health care providers can collaborate to provide their services in a cost-effective manner that optimizes quality of care and comprehensive health care.     

New directions for the education of clinical psychologists: The primary care setting,the VA's PRIME program,and the in-depth generalist model

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an in-depth generalist (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.     

Primary and secondary reflection in existential family therapy

The author uses Gabriel Marcel's topology of primary and secondary thought to clarify and outline the process of reflection in Existential Family Therapy. Clinical material is used to illustrate the differences between primary and secondary reflection during the practice of Existential Family Therapy.     

A biopsychosocial therapeutic approach in a private outpatient clinic in Portugal

Patients with chronic stress and ambiguous symptoms are likely to be more frequent in primary care. Somatizers represent 75.8% of the patients in this study and executives 56% of the sample. Job stressors were present in 78.3% of executive men. This scenario suggests that the primary care physician has to be academically better prepared to fully understand and deal with stress problems in daily clinical practice. The physician must have skills to deal with stress at a curative and preventive level, extending those skills to the workplace.     

Psychopathy and structure of primary mental abilities

The Comprehensive Ability Battery (CAB) was used to assess 18 primary mental abilities in 53 white, male prison inmates for whom highly reliable ratings of psychopathy were available. None of the correlations between ratings of psychopathy and scores on the CAB tests was significant, and the overall pattern or structure of abilities was the same for inmates with low and high ratings of psychopathy. The possibility is raised that the personality characteristics of psychopaths make them appear to be brighter and more creative than they actually are. Compared with norms for male high school students, the inmates as a group generally performed well, falling near the 50th percentile on 11 of the tests. The inmates performed significantly better than the normative sample on tests of verbal ability, esthetic judgment, aiming, and representational drawing, and significantly worse on tests of ideational fluency, spontaneous flexibility, and word fluency.This research was supported by Grant MT-4511 from the Medical Research Council of Canada.     

Peer tutoring among elementary students: educational benefits to the tutor

To determine whether tutoring might be academically beneficial to the tutor, this study investigated the acquisition of spelling words by three elementary students in a peer tutoring program. The experimental design allowed a simultaneous comparison of each child's gain in performance on comparable word lists on which the child tutored another child, was tutored by another child, or neither gave nor received tutoring. The children's spelling improved nearly an equivalent amount on those words on which they tutored another child as on the words on which they were tutored; no such change was noted on the words on which they neither gave nor received tutoring. These findings, that peer tutoring is profitable for the tutor as well as the tutee, provide a basis for recommending peer tutoring as one method of individualizing education.