Medical Psychology in Australia

Medical psychology in Australia is heavily influenced by British and American thought. The dominant model for clinical training and practice is the scientist–practitioner model, yet a gulf exists between academic and practice settings. Membership of the professional society requires 6 years of university study in psychology. However, registration requires only 4 years training in psychology. Medical psychologists provide a broad range of services in hospital and community settings, often within multidisciplinary teams. Challenges for the future include bridging the divide between university and health settings, increasing qualifications required for registration, making psychology culturally relevant, and demonstrating to funding managers that psychological interventions are both clinically effective and cost effective.     

Referral Source Differences in Functional Impairment Levels for Children Served in the Comprehensive Community Mental Health Services for Children and Their Families Program

We report one of the first multi-site investigations into referral source variation in functional impairment for children with serious emotional disturbance served in systems of care settings. Baseline data collected as part of the national evaluation for the Comprehensive Community Mental Health Services for Children and Their Families Program was used to assess the comparability of functional status for children referred from traditional mental health versus non-mental health agencies. Results indicate that children referred from child welfare and family groups have significantly lower levels of overall dysfunction than those referred from mental health, while children referred from school and juvenile justice agencies have comparable levels. Clinical and research implications are discussed.     

The Current State of Medical Psychology in Iran

This paper reviews medical psychology in Iran and describes the two major professional associations representing the profession. The unique role of religion in Iran is stressed, and limitations of the current health care system are described. The paper also addresses human resource issues and the educational requirements for the practice of psychology in Iran.     

A Test and Refinement of the Demand–Control–Support Model in the Construction Industry

This study aims at a test and further refinement of the Demand–Control–Support (DCS) model among construction workers (N = 210). On the basis of theory and empirical evidence, we hypothesized that mental or physical job demands, low job control, and lack of social support at work have direct and synergistic effects on burnout. The model was expanded by hypothesizing that burnout mediates the relationships between these potentially demanding working conditions on the one hand, and health complaints on the other. Results of a series of structural equation analyses partly supported these hypotheses. The proposed model fitted adequately to the data, although some variables in the DCS model did not make a unique contribution to explaining variance in burnout and (indirectly) health complaints. Interestingly, lack of social support was the most important determinant of burnout and health complaints among construction workers. In addition, a significant three-way interaction effect partly confirmed the synergism hypothesis: Physical demands were only related to burnout if participants had poor job control and reported high social support. The implications of these findings for research and practice are discussed.     

Managing Job Stress in the Netherlands

Compared with other countries, in the Netherlands work pressure and sickness absenteeism and work incapacitation rates due to work-related mental health problems are quite high. About a decade ago a new Working Conditions Act (WCA) was introduced that had far-reaching consequences for the way job stress is dealt with in organizations. The WCA emphasizes the central role to be played by commercially operating Occupational Health and Safety Services (OHSSs), and it defines a new kind of professional—the Work & Organizational Expert—who is primarily responsible for the assessment and prevention of job stress. Recently, a number of instruments have been developed for psychosocial risk assessment that are now widely used on a regular basis in a way prescribed by the WCA. Preventive measures are increasingly taken by organizations in order to reduce job stress and sickness absenteeism. Based on the Dutch approach some lessons may be learned. Recommendations pertain to (1) the role of government, (2) legal recognition of psychosocial work factors, (3) the privatization of the occupational health and safety sector, and (4) evaluation of job stress prevention programs.     

Primary Care and Clinical Psychology: Assessment Strategies in Medical Settings

There is ample evidence regarding medical-psychological comorbidity to consider clinical psychology as a viable component of health care services in medical settings. Psychologists can become valuable assets to primary care physicians who treat a high number of primary psychiatric cases as well as medical cases with secondary psychological symptoms. Psychologists who function in hospital-based clinics as well as affiliates with primary care (PC) offices can provide empirically supported assessment services that can make treatment more effective and efficient. Multiple studies indicate high prevalence rates of psychiatric patients in PC settings using various instruments. This paper reviews selected assessment tools that have established diagnostic validity and reliability that can be both strategic for patient care and useful to reinforce psychologist collaboration with primary care physicians (PCP).     

Patterns of Natural Language Use: Disclosure, Personality, and Social Integration

When people write about their deepest thoughts and feelings about an emotionally significant event, numerous benefits in many domains (e.g., health, achievement, and well-being) result. As one step in understanding how writing achieves these effects, we have developed a computer program that provides a "fingerprint" of the words people use in writing or in natural settings. Analyses of text samples indicate that particular patterns of word use predict health and also reflect personality styles. We have also discovered that language use in the laboratory writing paradigm is associated with changes in social interactions and language use in the real world. The implications for using computer-based text analysis programs in the development of psychological theory are discussed.     

卫生系统绩效评估及其思考—《2000年世界卫生报告》的启示与思索

世界卫生组织在《2000年世界卫生报告－卫生系统：改进绩效》中,对191个成员国的卫生系统绩效进行了评估和排序。介绍了这一评估的框架和主要结果;提出对卫生系统绩效评估的启示与思考,认为我国应反思卫生改革绩效并客观地作出评价,为在新世纪促进卫生系统更好地发展和调整卫生改革目标作出明智的选择。     

通过发展区域规划建设更加健康的未来

论述有关城市在这个更大范围的地区和全球系统中的位置,以及这些系统对城市和城市居民“健康”的影响。提出倡议:为了建设更健康的未来,城市需要参与并且对其地域生态的发展产生影响,而作为一个全方位的改革的一部分,城市应该将健康和人类的发展作为关注的重点。     

抗战时期四川公共卫生事业发展的契机

四川地处中国西南,居祖国内陆,多山地丘陵,交通不便,较为闭塞。全面抗战初期,四川政治、经济、文化相对落后,卫生条件也较为简陋,在全国医疗卫生水平排名中处于较低地位。而在国民政府迁都重庆后,四川成为抗战领导组织的核心地区,占据重要的战略地位。战略地位的改变,带来了卫生资源的调整,医疗卫生需求的急剧增加和国内外卫生发展支持力量的帮助,给四川医疗卫生发展以难得的机遇。抗战时期四川公共卫生事业的发展对当时四川的社会稳定和抗战胜利提供了有力的保障,并奠定了战后四川医疗卫生事业大省的地位。