Effects of Intimate Partner Violence on Low-Income Women’s Health and Employment

Rates of both intimate partner violence and poor health are high among low-income women This paper examines relationships among abuse, health, and employment stability using data from a 3-year study of over 1000 female welfare recipients in Illinois. Results demonstrate the importance of accounting for both recency and chronicity of intimate partner violence and understanding the mediational role of health in the relationship between intimate partner violence and employment. Chronic intimate partner violence is associated with poor health, whereas recent intimate partner violence is associated with unstable employment. Mediations analyses suggest that health does not mediate the effects of abuse on employment stability over a 3-year period.     

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.     

The Double Life of Double Effect

The U.S. Supreme Court's majorityopinion in Vacco v. Quill assumes thatthe principle of double effect explains thepermissibility of hastening death in thecontext of ordinary palliative care and inextraordinary cases in which painkilling drugshave failed to relieve especially intractablesuffering and terminal sedation has beenadopted as a last resort. The traditionaldoctrine of double effect, understood asproviding a prohibition on instrumental harmingas opposed to incidental harming or harming asa side effect, must be distinguished from otherways in which the claim that a result is notintended might be offered as part of ajustification for it. Although double effectmight appropriately be invoked as a constrainton ordinary palliative care, it is not clearthat it can be coherently extended to justifysuch practices as terminal sedation. A betterapproach would reconsider double effect'straditional prohibition on hastening death as ameans to relieve suffering in the context ofacute palliative care.     

Predicting who benefits from psychoeducation and self help for panic attacks

Self-help and psychoeducation have been identified as effective methods for delivering treatment, yet not everyone benefits from these brief interventions. Therefore it is clinically and economically useful to identify who is likely to require more intensive assistance. This paper develops a prognostic scale which predicts who will recover from panic attacks and who will require more assistance. Method: Random regression models were used to evaluate the relationship between predictive variables, baseline severity, and the rate of improvement in 117 people with DSMIV panic attacks who participated in a trial of a psycho-educational booklet, a self-help workbook, and brief group CBT over a 9-month period. ROC analysis was used to choose cut-off points on a scale made up of significant predictors. Results: Panic disorder and agoraphobia symptom measures were predicted by baseline social anxiety, and general mental health. There was no significant effect on the outcome for baseline depression or anxiety sensitivity. While general mental health (SF12 Mental Component scores) was predicted by the age at first panic attack, neuroticism, panic disorder and/or agoraphobia symptoms and a positive screen for alcohol use disorders. A prognostic scale based on simple additive scoring was equivalent to standard scores and significantly better than chance at predicting who would recover and who required face-to-face therapy. Conclusions: The prognostic scale may be used to guide the choice of psychoeducation, self-help or face-to-face therapy as the first step in stepped care.     

Norwegian versions of the Living with Asthma Questionnaire (LWAQ) and Asthma Bother Profile (ABP), validation and comparison of two asthma groups

The Living with Asthma Questionnaire (LWAQ) and the Asthma Bother Profile (ABP) were translated into Norwegian using conventional back translation procedures, and completed by 30 asthma outpatients and 30 asthma patients admitted to inpatient rehabilitation. Reliability (Cronbach's alpha and retest-reliability) was shown to be good for both scales. Validity was established by showing significantly poorer health in the rehabilitation sample, and correlations with state and trait anxiety. The Norwegian translations are reliable and valid versions of the original questionnaires.     

Brief training to promote the use of less intrusive prompts by nursing assistants in a dementia care unit

We evaluated the efficacy of a brief staff-training procedure to increase the use of graduated prompting by 2 certified nursing assistants (CNAs) while they helped to dress 3 persons with dementia in a seven-bed dementia care unit. The multiple baseline design across participants showed that CNAs dressed residents with minimal resident involvement during baseline observations. Following brief in-service training, CNAs provided graduated prompts and praise appropriately, suggesting that CNAs can promote active involvement in personal care routines by older adults with dementia.     

Unemployment, Underemployment, and Mental Health: Conceptualizing Employment Status as a Continuum

The economy is one of the most important social environments that affect well-being, and community psychologists have long studied the social costs of one key economic stressor—job loss. But economically inadequate employment has received much less research attention than unemployment in regard to mental health effects. This paper contrasts these two literatures and considers factors that might account for their differential growth including actual rates of unemployment and underemployment. Recent panel studies offer no support for another possible basis for this differential growth—the assumption that inadequate employment is more like adequate employment than unemployment. Implications of a paradigm shift from a dichotomous perspective (employment vs. unemployment) to a continuum perspective with variations of both unemployment and employment are discussed for research and prevention. Another implication is the need to expand standard labor force statistics to reflect better the degree of underemployment.     

The Role of Creativity in Marriage and Family Therapy Practice: A National Online Study

The purpose of this study, using an online methodology, was to investigate therapists' perceptions of the role of creativity in couples' and family therapy. Along with completing a quantitative measure assessing creativity in their work, participants responded to four open-ended questions which addressed the meaning of creativity, characteristics of a creative family therapist, some creative interventions they have used with couples and families, and barriers to their own creativity as a family therapist. A total of 142 marriage and family therapists in 36 states in the United States participated. The findings shed light on the unique importance of creativity in couples and family treatment.     

健全社区卫生服务功能与防控"非典"传播的理性思考

针对我国当访“非典”防治工作的严竣形势,对健全社区卫生服务“六位一体”功能与防控“非典”传播问题进行哲学思考,着重在健全社区卫生服务功能是防控“非典”传播的客观要求;社区卫生服务功能不全将会对防控“非典”工作产生不利影响;构筑防控“非典”传播的有效机制和基础防线,必须健全社区卫生服务功能等方面作了分析论述。