The Mpowerment Project: community-building with young gay and bisexual men to prevent HIV1

The Mpowerment Project is a community-level HIV prevention intervention for young gay and bisexual men ages 18–27. The program seeks to build a strong, supportive young gay and bisexual men's community where young gay and bisexual men nurture and protect each other, particularly with regard to HIV prevention. The program's theoretical framework draws from the areas of diffusion of innovations, community organizing, peer influence, and personal empowerment. The Mpowerment Project promotes a norm for safer sex through a variety of social, outreach and small group activities. The project is run by a Core Group of 12–15 young gay and bisexual men who, with volunteers, design and carry out all project activities. Implemented in 4 communities (Eugene, OR; Santa Barbara, CA; Albuquerque, NM; Austin, TX), the Mpowerment Project has proven to be effective in reducing high risk sex. This paper discusses the development and implementation of the program and various challenges encountered.     

透视医疗纠纷——辨析医患双方的权利和义务

发生医疗纠纷的一个重要原因是医患双方各自站在自己的立场上,维护自己的权利而产生的争端。由于我国卫生法制的滞后,患者被作为消费者伸张权利逐步成为趋势。但我国的医疗卫生事业的性质决定患者不能与消费者等同。医患双方应在更好的游戏规则下协调关系,减少纠纷。     

Betrayal And Paranoia: The Psychotherapist's Function as an Intermediary

We present an approach to the problem of structuring a therapeutic alliance with patients presenting paranoid symptoms, using both psychoanalytical and cognitive techniques. Initially, we focused on one of the main aspects of the paranoid worldview: the fear of being betrayed and the tendency to betray. This is a defense maneuver, through which patients deny their passivity, and the impotence in the relationship with their own internal needs and with the significant people in the external world, including the therapist. In our experience to build up a working relationship, both a psychoanalytical interpretation of unconscious conflicts and the cognitive analysis of dysfunctional beliefs are needed. Often, in more serious cases, the role of nonqualified object must be accepted at the beginning, due to the patient's need to be in control of the situation. Only then can a therapeutic phase begin, in most cases, through an integrated approach that includes pharmacological, psychodynamic, and cognitive modalities.     

对影响病人满意度相关因素的医学伦理思考

设计调查问卷对深圳某基层医院实施病人满意度调查及相关因素的医学伦理分析。结果显示病人满意度不高,门急诊病人的总满意度明显低于住院病人;病人对服务态度、就医环境和诊疗费用等都较不满意。其中医院未能遵循及时、准确、有效、择优和自主原则是主要影响因素。     

Clinical Psychology Students’ Experiences of a Pilot Objective Structured Clinical Examination

There is a need to improve methods used to assess students’ clinical skills in postgraduate clinical psychology training, but research into the use of new competency‐based assessments are sparse. The current study examines the potential application of the objective structured clinical examination (OSCE) to clinical psychology training. Commonly used in medical training, the OSCE requires students to demonstrate clinical skills across a number of standardised stations with trained actors playing the part of patients. A pilot OSCE was conducted with nine students from a psychology doctoral program. Participants completed a brief student feedback questionnaire and attended a focus group after the OSCE. They also completed the State–Trait Anxiety Inventory before and after the OSCE. The results showed that students viewed the OSCE as a valid, realistic, and fair assessment method. They reported high levels of anxiety during the OSCE but noted that the OSCE was a positive learning experience. These results suggest that OSCEs should be considered in clinical psychology training programs for the assessment of clinical competence. Further evaluations of the validity and reliability of the clinical psychology OSCE using a larger sample size are required. Other limitations and implications of the study are discussed.     

Bion's Notes on memory and desire – its initial clinical reception in the United States: A note on archival material

While Bion's 1967 memory and desire paper reflected a crucial episode in his clinical thinking during his epistemological period, it was also central to his evolution as a Kleinian psychoanalyst who worked with seriously disturbed adult patients. The author explicates and contextualizes these claims with a new archival document, the Los Angeles Seminars delivered by Bion in April 1967, and the full‐length version of Notes on memory and desire. Bion here instigated a radical departure from years of theory‐laden work when he made his clinical work and ideas accessible to a new audience of American Freudian analysts. While this new group was keenly interested to hear about Bion's clinical technique with both borderline and psychotic patients, there were varied reactions to Bion's ideas on the technical implications of the analyst's abandonment of memory and desire. Both the Los Angeles Seminars and Notes elicited responses ranging from bewilderment, admiration to skepticism amongst his audience of listeners and readers. These materials also however allow for a more complete and systematic presentation of important ideas about analytic technique – and while his ideas in this domain have been long valued and known by many psychoanalysts, this contribution stresses the crucial aspect of the reception of his ideas about technique in a particular American context. American analysts gained a much more explicit idea of how Bion worked analytically, how he listened, formulated interpretations and factored in the analyst's listening receptivity in the here‐and‐now. The author concludes with a consideration of the importance of Bion's American reception in 1967.     

Questions of condom use in the Muslim and Catholic response to HIV and AIDS in Nairobi,Kenya

Religious leaders in Roman Catholic and Sunni Muslim communities in Kenya’s capital city of Nairobi are charged with responding in an official capacity to the pressing concerns facing their respective communities both theologically and practically. However, speaking about sexuality from a religious perspective particularly on the use of condoms in AIDS prevention has been rather troublesome topic many leaders and clergy find problematic discussing openly. This paper offers a comparative analysis of Muslim and Catholic views on sexuality by establishing the parameters within which to consider the presence and activity of Catholic and Muslim leaders in Kenya and the holistic, grassroots approach in responding to the AIDS epidemic in Nairobi regarding condom use.     

Does contact at work extend its influence beyond prejudice? Evidence from healthcare settings

This article reports on two studies investigating the role of intergroup contact on the reduction of prejudice against migrants and on organizational and health outcomes. Study 1 enrolled 624 native healthcare professionals and showed that frequent and positive contact with non-native co-workers was associated with a decrease in the professionals’ prejudice and an increase in the professionals’ perception of team functioning. These effects were mediated by reduced in-group threat perception. Study 2 enrolled 201 native patients and showed that frequent and positive contact with non-native healthcare providers was associated with a decrease in patients’ prejudice and an increase in patients’ satisfaction for the care received. These effects were mediated by reduced in-group threat perception. These novel findings showed that frequent and positive contact with non-native individuals can improve health and organizational outcomes along with facilitating positive intergroup relations.