The Factor Structure of the Beavers Interactional Scales

Confirmatory factor analysis and regression analyses of the Beavers Interactional Scales did not appear to support the model offered by its developers, namely, several specified family attributes contributing respectively to two global factors of Family Competence and Family Style. Moreover, regression analysis indicated that only three of 12 items predicted raters' assessments of Global Family Health, and one of seven items predicted Global Family Style. Individuals interested in the family dynamic centripetal/centrifugal might best think of that as a unitary entity and rate it accordingly.     

社会因素对剖宫产率的影响

近二三十年来,剖宫产率在世界范围内不断升高。究其原因,除了医学因素外,社会因素起着重要作用,从社会经济发展,社会科学文化水平、社会习俗观念、法律、医疗道德、国家计划生育政策、医学教育等多个角度分析了社会因素对剖宫产率的影响,并就如何发挥社会因素的积极作用,消除和避免其消极作用,使剖部率维持在合理的范围内进行了讨论。     

科学主义的尴尬与中医学的多向度发展

近５０年的中医现代化研究暴露了科学主义试图消解其他向度存在的独尊倾向,而经络实质研究、证客观化研究等方面的失败,宣告了科学主义并不是解决中医学所有问题的灵丹妙药。科学主义所遇到的这种尴尬局面表明,中医学应该有多种向度的发展,除了现代化研究这一模式之外,至少还应当有两种向度的存在,即原有形态的传统中医学体系应继续存在下去,传统中医学在技术上与西医学的结合应当受到鼓励。     

A Lesson from My Father

Simple acts can heal. And God is present in those simple and humble acts. The following is a true story that illustrates these truths, told from the perspective of eyewitness, son, and physician.     

Concordant Spiritual Orientations as a Factor in Physician--Patient Spiritual Discussions: A Qualitative Study

Objectives: To understand the impact of physicians and patients religious/spiritual orientation on discussions of spiritual issues. Methods: We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Results: Respondents expressed that similar belief systems facilitate patient–physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Conclusions: Our respondents view spirituality similarly to other aspects of the physician–patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions.     

On the existence and uniqueness of JML estimates for the partial credit model

A necessary and sufficient condition is given in this paper for the existence and uniqueness of the maximum likelihood (the so-called joint maximum likelihood) estimate of the parameters of the Partial Credit Model. This condition is stated in terms of a structural property of the pattern of the data matrix that can be easily verified on the basis of a simple iterative procedure. The result is proved by using an argument of Haberman (1977). The author wishes to thank the Editor and the anonymous reviewers for their comments that helped to substantially improve the final version of this paper. This research was supported in part by a MURST grant (ex 60%).     

Bilateral Art: Integrating Art Therapy,Family Therapy,and Neuroscience

This paper describes the systemic use of a neurologically-based art therapy modality—bilateral art—that engages both dominant and non-dominant hands in the process of creating images in response to opposing cognitions or feelings. It describes both neuroscience and family therapy perspectives that argue for the use of bilateral art. A specific protocol for bilateral art therapy is provided along with a case study demonstrating integration of the protocol into the systemic treatment of a young family. Carole M. McNamee, PhD, is Research Professor and Clinical Associate, Director of the Arts in Healthcare Project, The Family Therapy Center, Department of Human Development, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (cmcnamee@vt.edu).     

Indian Women’s Experience of a Narrative Intervention Using Art And Writing*

International and minority populations tend to underutilize mental health services, including marriage and family therapy. Models of marriage and family therapy developed in the West may reflect Western values and norms inappropriate for diverse cultural contexts. This article presents an exploratory, qualitative study of a narrative therapy approach with Asian Indian women. This study adds to the small body of narrative-based empirical studies, and has a unique focus on intercultural applications and the experience of participants. Participant experience was examined along four phenomenological dimensions. Findings indicate the suitability of narrative interventions and nontraditional treatment delivery for this population.*This research was presented in 2004 at the annual conference of the American Association for Marriage and Family Therapy.     

Communication flow and change theory within a family therapy supervision model

This article portrays a model of family therapy clinical supervision using change theory that is most appropriate for use with the videotape, audiotape, case presentation and debriefing from the live session. The most powerful tool during this process is that of communication and assessment of change theorys tools of confidence and conviction. The concepts presented are meant to add an additional dimension to family therapy supervision in cooperation of other theories, not as an end in themselves.Special thanks to Ms. Geri Koncilja of the Informational Technology Center at Colorado State University, Pueblo for illustration and graphic assistance.     

Care of the Self and Patient Participation in Genetic Discourse: A Foucauldian Reading of the Surgeon General's “My Family Health Portrait” Program

Critics of genetic discourse are concerned that deterministic and discriminatory views of genetics are increasingly becoming adopted. These views argue that current genetic discourse becomes a source of power whereby powerful institutions harm people with so-called “bad” genes. This essay argues that current analyses of the power of genetics discourse are grounded in an improper reading that disempowers patients. Deploying Michel Foucault's concept “care of the self,” this essay claims that genetics discourse is better understood as a way that patients take on power through rhetoric rather than a force that has power over patients. Through a close reading of the “My Family Health Portrait” program, this paper argues that patients experience a process of “subjection” wherein they become agents of and objects of genetics discourse both. This alternative mode of analyzing the power of genetics discourse has implications for our collective understanding of the operations of the care of the self and the uses of genetic information that we propose.