Participatory Organizational Change in Community-Based Health and Human Services: From Tokenism to Political Engagement

Community psychologists have long worked with community-based human service organizations to build participatory processes. These efforts largely aim at building participatory practices within the current individual-wellness paradigm of human services. To address collective wellness, human service organizations need to challenge their current paradigm, attend to the social justice needs of community, and engage community participation in a new way, and in doing so become more openly political. We use qualitative interviews, focus groups, organizational documents, and participant observation to present a comparative case study of two organizations involved in such a process through an action research project aimed at transforming the organizations’ managerial and practice paradigm from one based on first-order, ameliorative change to one that promotes second-order, transformative change via strength-based approaches, primary prevention, empowerment and participation, and focuses on changing community conditions. Four participatory tensions or dialectics are discussed: passive versus active participation, partners versus clients, surplus powerlessness versus collective efficacy, and reflection/learning versus action/doing.     

我国中小学生心理健康服务从业人员及工作状况调查

该研究的目的是考察我国中小学生心理健康服务从业人员及专业工作的基本情况,并比较其地区差异,分析存在的问题。调查包括来自重庆、甘肃、辽宁、福建、湖北以及西藏等6个省市自治区的596名被试。研究采用自编问卷调查中小学生心理健康从业队伍情况及其专业工作情况。结果发现各地区之间发展确实存在不均衡的状况,辽宁、福建等东部发达地区从业人员专业化水平相对较高;西藏、甘肃等地区则相对较为落后,特别体现在人员结构不合理、职称待遇偏低、缺少专业培训等方面。     

Individual attitudes and perceived social norms: Reports on HIV/AIDS‐related stigma among service providers in China

This study examined HIV/AIDS‐related stigma among Chinese service providers by comparing their personal attitudes toward people living with HIV/AIDS with their perception of social norms related to people living with HIV/AIDS. We randomly selected three provincial hospitals, four city/prefecture hospitals, 10 county hospitals, 18 township health clinics, and 54 village clinics from Yunnan, China. Doctors and nurses were randomly sampled proportionally to the doctor–nurse ratio of each hospital or clinic. Lab technicians were over‐sampled in order to include an adequate representation in the analysis. A total of 1,101 service providers participated in a voluntary, anonymous survey where demographic characteristics, individual attitude and perceived social norms toward people living with HIV/AIDS, discrimination intent at work, general prejudicial attitude and knowledge on HIV/AIDS were measured. A majority of the sample demonstrated a similarity between their personal views and what they thought most people in society believe. Multiple logistic regressions revealed that participants who were younger or reported personal contact with people living with HIV/AIDS were significantly more likely to report personal attitudes toward the population that were more liberal than their perceived social norms. Holding a more liberal personal attitude toward people living with HIV/AIDS than perceived social norms was significantly and negatively related to the level of discrimination intent at work, perceived discrimination at interpersonal level and the level of general prejudicial attitude toward people living with HIV/AIDS. Results underscored the importance of understanding social norms and personal attitudes in studying HIV‐related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs.     

Inhibitory response capacities of bilateral lower and upper extremities in children with developmental coordination disorder in endogenous and exogenous orienting modes

This study was designed to investigate separately the inhibitory response capacity and the lateralization effect in children with developmental coordination disorder (DCD) in the endogenous and exogenous modes of orienting attention. Children with DCD on the lower extremities (DCD-LEs), along with age-matched controls, completed four tasks that involved various applications of asynchronous stimuli to the feet or hands at various intervals. The results demonstrated that children with DCD-LEs had a significantly longer reaction time than the controls for all tasks, and were not alert to the appearance of the target. However, they displayed a deficit in volitional shifts of attention (endogenous mode), but not in automatic dislocation of attention (exogenous mode), whenever they performed the tasks with either their lower or their upper-limbs-even 6 months after the initial study. These findings confirm the deficit in the inhibitory response capacity in terms of volitional movement of attention by children with DCD. Additionally, the negative effect of lateralization on the bilateral extremities was not present in children with DCD-LEs. Significantly differences in response ability were detected only between the dominant and non-dominant sides of upper-limbs, but not between the lower-limbs, suggesting a future avenue for further experimentation on bilateral extremities.     

Mechanisms of deficit of visuospatial attention shift in children with developmental coordination disorder: A neurophysiological measure of the endogenous Posner paradigm

The purpose of this study was to investigate and compare the mechanisms of brain activity, as revealed by a combination of the visuospatial attention shifting paradigm and event-related potentials (ERP) in children with developmental coordination disorder (DCD) and typically developing children. Twenty-eight DCD children and 26 typically developing children were recorded with regard to their behavioral performance and ERP measures during a variant of the endogenous Posner paradigm, in which they should react to visual targets preceded by spatial cues or presented uncued. Children with DCD showed longer reaction time and a deficit in inhibitory response capacity when compared to typically developing children. The electrophysiological characteristics also showed distinct modulatory effects upon attentional orienting, anticipatory mechanisms, and cognitive-to-motor transfer in children with DCD: longer cue-P3 and target-N1 latency, smaller target-P3 amplitude, an elongated interval between N2 and the motor response (N2-RT), and small areas on contingent negative variation (CNV). The combined analysis of behavioral performance and ERP data suggested that children with DCD had deficits of slower target identification (N1), less ability in interhemispheric (P3) and cognitive-to-motor transfer speed (N2-RT), as well as a less mature anticipatory and executive process (CNV).     

Manual dexterity in the gorilla: bimanual and digit role differentiation in a natural task

The manipulative actions of mountain gorillas Gorilla g. beringei were examined in the context of foraging on hard-to-process plant foods in the field, in particular those used in tackling thistle Carduus nyassanus. A repertoire of 72 functionally distinct manipulative actions was recorded. Many of these actions were used in several variants of grip, finger(s) and movement path, both by different individuals and by the same individual at different times. The repertoire appears somewhat greater than that observed in comparable studies of monkeys, but a far more striking difference is found in the use of differentiated actions in concert. Mountain gorillas routinely and frequently deal with problems that involve: (1) bimanual role differentiation, with the two hands taking different roles but synchronized in time and space, and (2) digit role differentiation, with independent control of parts of the same hand used for separate purposes at the same time. The independent control that allows these abilities, so crucial to human manual constructional ability, is apparently general in African great apes. Role differentiation, between and within the hand, is evidently a primitive characteristic in the human arsenal of skills. Accepted after revision: 6 April 2001 Electronic Publication     

Psychiatric disorders and the use of mental health services among children involved in bullying

This study had two aims: to evaluate the relationship between bullying and psychiatric disorders and to study the probability of using mental health services among children involved in bully/victim problems. The data consisted of interviews with 423 parents and 420 children. Diagnostic measures were based on the Isle of Wight Interview. Children involved in bullying as bullies, bully‐victims, and victims were compared with other children. Children involved in bully/victim problems were more prone to have psychiatric disorders than noninvolved children. The probability of being disturbed was highest among male bullies, followed by male bully‐victims and female victims (9.5‐fold, 7.9‐fold, and 4.3‐fold, respectively) compared with noninvolved same‐sex children. The most common diagnoses among children involved in bully/victim problems were attention deficit disorder, oppositional/conduct disorder, and depression. Furthermore, children involved in bully/victim problems were more likely to have used mental health services at some time during their lives and also during the previous 3 months. Special attention should be paid to children’s mental health when dealing with bullying problems at school. Referral pathways to mental health services and factors affecting the referral processes among children should be further studied. Aggr. Behav. 27:102–110, 2001. © 2001 Wiley‐Liss, Inc.     

论当前我国医疗市场对医患关系的影响

解读目前紧张的医患关系是一个迫切的社会课题。医疗服务是一种商品 ,医疗市场是客观存在的 ,它是导致医患关系紧张的深层次原因。     

政策环境对实现残疾人康复服务的影响

根据《上海市残疾人"人人享有康复服务"评价指标体系》,采用综合评价法,对上海市6个区残疾人康复工作进行评价。研究发现,残疾人康复政策环境实现率为96.3%,5个二级指标实现率均超过80%,三级指标达标率63.3%。应明确残疾人康复工作的重要性,将残疾人康复纳入政策工作计划,各区残疾人康复政策环境建设应协调平衡发展。