The right to a decent minimum of health care

Buchanan examines, and finds inadequate, several philosophical approaches to justifying and specifying the content of a universal right to a decent minimum of health care: utilitarian arguments, Rawlsian ideal contract arguments, and Norman Daniels' equality of opportunity argument. Also rejecting the libertarian hypothesis that there is no right to a decent minimum of care, he contends that the claim that society should guarantee certain health care services can be supported by a pluralistic approach encompassing special right-claims, harm prevention, prudential arguments emphasizing public health benefits, and beneficence.     

Assessing the stability of principal components using regression

This paper presents an analysis, based on simulation, of the stability of principal components. Stability is measured by the expectation of the absolute inner product of the sample principal component with the corresponding population component. A multiple regression model to predict stability is devised, calibrated, and tested using simulated Normal data. Results show that the model can provide useful predictions of individual principal component stability when working with correlation matrices. Further, the predictive validity of the model is tested against data simulated from three non-Normal distributions. The model predicted very well even when the data departed from normality, thus giving robustness to the proposed measure. Used in conjunction with other existing rules this measure will help the user in determining interpretability of principal components.The authors would like to thank the four anonymous reviewers and the two editors for their valuable comments. Atanu R. Sinha gratefully acknowledges the research support received from the Marketing Studies Center, AGSM, UCLA. Send requests for reprints to Atanu R. Sinha, B418 Gold Hall, 110 Westwood Plaza, Los Angeles, CA 90095.     

Marriage and family therapy with people from China

On the basis of personal experience and understanding of the Chinese culture as a native of the People's Republic of China, the author gives some of the reasons why Chinese-Americans under-utilize mental health facilities and addresses issues that might arise in marriage and family therapy with people from China. Subcultural differences and variables such as the place of origin, intraracial or inter-racial marriage, that need to be considered in the assessment phase are stressed, along with treatment interventions that are or are not culturally compatible. Behavioral, structural, and brief therapy models are recommended. The experiential model should be used with caution with Chinese clients.     

Long term marriages in Sweden: And some comparisons with similar couples in the United States

This international, five-country long term marriages study of couples who have been married, or unmarried and cohabiting, for 20 years or longer is designed to study, among other things, marital satisfaction. This first report of the Swedish part of the study reports on a Swedish version of the self-rating Dyadic Adjustment Scale (DAS) used to investigate self-rated marital satisfaction. The couples describe high marital satisfaction and a high sense of coherence (SOC) compared to other groups. Contrary to other studies, no differences were found between men and women regarding SOC. The differences between them, that describe high relative to low marital satisfaction, pertain to matters of recreation, sex, life philosophy, time spent together, and frequency of quarrels. The men reported greater marital satisfaction than the women.     

Boundary regulation in family and personal systems: Perceptions of late adolescents

Examination of boundary regulation can provide family therapists with a framework to describe both the functioning of family systems and personal systems (i.e., the intrapsychic functioning of individual family members). In the present study, late adolescents' perceptions of boundary regulation within their family systems (i.e., ratings of family health, communication, leadership, expressiveness, cohesion, and family conflict) were related to regulation of their personal boundaries (i.e., self-reported personal competence, distress, and patterns of defense mechanism use). In addition, personal system variables reliably discriminated between adolescents who described their families as psychologically healthy versus psychologically unhealthy.     

Respect: Response to shame in health care

Shame is a not uncommon experience of patients in health care settings. Religious assessments often confuse shame with guilt, and therefore respond in ways that may not be appropriate. Illustrated by a case study, this article distinguishes shame from guilt and examines systemic considerations. Then shame is explored in relation to traditional, negotiating, and individualistic belief paradigms, looking at epistemology, causality, response to shame, healing models, and tasks. It concludes with a discussion of the idea of respect as foundational for responding to people experiencing shame in health care.     

Engagement and recruitment for family therapy research in community settings

Based on the recruitment experience in a family therapy research project with heroin addicts, this paper explores the difficulties of researcher networking with other social service agencies. Concepts from contextual family therapy are used to explore four general areas that contribute to successful intra-agency relationships: 1) Evaluating the nature of larger system relationships; 2) identifying the resources and needs of a clinic; 3) joining with the counseling staff; and 4) addressing the impact of public policy and ideology on clinic life. A case of engaging one clinic is presented and nine guidelines for engaging large community settings for participation in family therapy research are offered. These areas are considered in light of the relational dynamics that arise when working with multiple social service systems.An earlier version of this paper was presented at the American Family Therapy Association conference in Washington, DC, June 1986. The authors are grateful to the recruitment staff of the Intergenerational Family Therapy Project: Guillermo Lopez, Bart Rubin, Sharara Godfry, and Armando Chenyek. This research was supported in part by a grant to Guillermo Bernal from the National Institute on Drug Abuse (DA03543).     

Interaction of Combat Exposure and Unit Cohesion in Predicting Suicide‐Related Ideation Among Post‐Deployment Soldiers

Suicide is one of the leading causes of death among U.S. Army soldiers. Suicide‐related ideation, which is associated with suicide attempts and suicide, can cause considerable distress. In a sample of 1,663 recently redeployed soldiers, we used factor analysis and structural equation modeling to test the associations between combat exposure, unit cohesion, and their interaction in predicting suicide‐related ideation. We found that combat exposure was a significant risk factor for suicide‐related ideation, while unit cohesion was a significant protective factor. The significant interaction between the two factors indicated that soldiers who experienced greater combat exposure but also had higher levels of unit cohesion had relatively lower levels of suicide‐related ideation. In addition, those who had higher levels of combat exposure and lower unit cohesion were most at risk for suicide‐related ideation. Our findings indicate the importance of unit cohesion in protecting soldiers from suicide‐related ideation and suggest a higher risk group of soldiers who should be targeted for interventions.     

权力、知识和精神病学主题——福柯的视角

精神病学领域有关权力因素的讨论日渐增多,法国哲学家福柯对权力和知识的含义及其关系进行了讨论,同时也对当代精神病学领域的相关的主题,如精神疾病、精神病院、诊断、治疗等,提出了批判性的思考,指出了其中隐含的权力因素及其历史性、文化性构成,有助于我们重新理解精神病的主题,更加关注人文因素的强大作用