The health needs of the majority versus the health needs of the individual: The reorganization of medical education in Colombia

The challenge of excellence in community health services has been taken up by medical educators in Colombia. Confronted with a nation where the primary indicators of disease mortality and morbidity (cardiovascular disease and infant mortality) were characteristic of First and Third World patterns, respectively, the Ministry of Health and La Asociacion Colombiana de Facultades de Medicina (ASCOFAME), representatives of institutions of medical education, have collaborated to conduct a needs assessment of the country's health needs and devised an implementation plan designed to better address the needs of the majority of that nation's people.As a model, the Colombian reorganization of medical education is an example which could be emulated by the U.S. where policy makers are struggling with troublesome questions of cost, equity and quality.     

Delineating the Structural Precursors and Cognitive Consequences of Personal Powerlessness: the Filipino Woman's Experience

Adopting a structural-cognitive perspective and path analysis, this study demonstrates that personal powerlessness generates sequelae of maladaptive cognitions, namely, low self-esteem, low success expectancies and a weak motivation for self-improvement. Despite adverse structural and natural forces, Bicolano women exhibited self-efficacy, high self-esteem, and strong propensity for self-improvement, albeit expressing low success expectancies. These constructive cognitions can be attributed to the women's strong achievement ethic, high educational attainment, and supportive kinship system. These factors also compensate for the depressive effects of low success expectancies on the motivation for self-improvement. Implications for empowerment strategies and cognitive literature are discussed.     

Exploring the relationships between pedestrian behaviours and traffic safety attitudes in six countries

The majority of cross-cultural research on traffic safety has investigated driver behaviour, yet in most low- and middle-income countries, where the weight of the road fatality burden is felt, motorisation rates are significantly lower than in higher-income countries. As such, this approach necessarily excludes large parts of the populations in those settings. In order to investigate the link between traffic safety attitudes and road user behaviours, this study used a self-report measure of pedestrian behaviour, applying it in six countries; Bangladesh, China, Kenya, Thailand, the UK, and Vietnam. Focus was on the relationships between a respondent’s attitude towards risky or rule violating on-road behaviours (of other road users, or more generally, not specific to pedestrians), and the extent to which they reported performing three types of risky pedestrian behaviours (i.e., intentional rule violations, errors in judgement or memory, and aggressive behaviours). Data from a sample of 3,423 individuals was subjected to a series of regression models, revealing significant links between attitudes and pedestrian behaviours in all countries, in all three behavioural factors, after controlling for age, gender, and exposure to the road environment. Differences were found between countries in the strength of these relationships, with weaker connections between attitudes and behaviours in Kenya, and stronger connections in China (with other countries in-between the two). Results are discussed in terms of the need to understand the relationships between social cognitive constructs in the specific country in which a road safety intervention is intended to be implemented.     

The early acquisition of verb meaning in German by normally developing and language impaired children

The research reported here focuses on the early acquisition of event structure in German. Based on longitudinal studies from 5 normally developing (ND) and 6 language-impaired (LI) children, a model of "event structural bootstrapping" is presented that spells out how ND children log into the verb lexicon. They project a target-consistent event tree, depicting the head-of-event of transitions. Young LI children, failing to employ this bootstrapping strategy, resort to radically underspecified event representations. The results from a truth-value judgment experiment with 16 ND and 16 LI children showed that ND children perform correctly on transitional verbs, while LI children perform at chance level on the same tasks. These findings are accounted for by the model of event structural bootstrapping to the extent that LI children lack an explicit representation of the head-of-event.     

Social and political perspectives on the psychotherapy and counselling profession: Returning caravelles

The counselling and psychotherapy profession is changing. For the first time in its history, it has begun to receive substantial Government funding in the UK and it also has to contend with the principles of evidence-based practice and the policies of the New Public Management systems in many countries. This paper argues that such recent developments present challenges to the profession’s historical apolitical standpoint. More importantly, it argues that the present social and political climate offers many opportunities such as the possibility of learning from psychosocial practices in other countries. The paper will look, in particular, at what can be learned from Latin America and India where mental health care and psychological therapy have adopted grassroots involvement, health-focused approaches and innovatory therapeutic methods.     

Application of Multi‐Criteria Analysis on Climate Adaptation Assessment in the Context of Least Developed Countries

The developing countries are suffering the most because of climatic variability and they have an enormous backlog in basic infrastructure to protect their cities. In addition, the resources and technical expertise are limited. Therefore, the adaptation measures to protect their cities are needed to be planned and prioritized carefully to reduce the vulnerability simultaneously considering the risk reduction, local constraints and development goals. A framework for prioritization of adaptation measures is lacking in the decision making in this context which could immensely assist in informed and structured decisions during the planning process of adaptation strategies in developing countries. This paper is exploring the potential of Multi‐Criteria Analysis as a methodology for climate adaptation assessment in order to prioritize the adaptation measures to be undertaken. Hence in this paper Adaptation assessment is conducted within the framework of Multi‐Criteria Analysis methodology which allows both normative judgement and technical expertise in the assessment process. Such a participatory integrated assessment of adaptation options is a new approach in flood management in least developed countries. The assessment framework has been applied and tested at the Eastern fringe of Dhaka city which is highly vulnerable to flooding. Based on the assessment and analysis, adaptive measures are prioritized to enable more effective action. Copyright © 2016 John Wiley & Sons, Ltd.     

The Baltic Churches and the Challenges of the Post-Communist World

This article analyses and describes the recent history of the Baltic churches, their theological reorientation and the challenges they have encountered in the post-Communist Baltic society. The focus is on the Estonian, Latvian and Lithuanian Lutheran churches whereas the Catholic and Orthodox churches receive less attention. It is first demonstrated that much has changed since the Second World War regarding the churches' membership numbers and their societal position. The article then pays attention to two phenomena that have caused much discussion not only within the churches but also among foreign observers: the fear that the Lutheran Church will surrender to the Catholic Church, and the quite opposite anxiety that the Lutheran Church–Missouri Synod will grow too influential within Baltic Lutheranism. Finally, the author examines the way the Baltic churches have been involved in politics during the last two decades.     

Thirty Years Later: An Oncologist Reflects on Kubler-Ross's Work

As compared with conventional vaccine production systems, plant-made vaccines (PMVs) are said to enjoy a range of advantages including cost of production and ease of storage for distribution in developing countries. In this article, we introduce the science of PMV production, and address ethical issues associated with development and clinical testing of PMVs within three interrelated domains: PMVs as transgenic plants; PMVs as clinical research materials; and PMVs as agents of global health. We present three conclusions: first, while many of the ethical issues raised by PMVs are familiar, PMVs add a new dimension to old issues, and raise some novel issues for ethicists and policy-makers; secondly, it is premature to promise broad applicability of PMVs across the developing world without having demonstrated their feasibility; thirdly, in particular, proponents of PMVs as a solution to global health problems must, as a condition of the ethical conduct of their research, define the commercial feasibility of PMVs for distribution in the developing world.     

21世纪易经文献学研究展望

易学研究是当代国学研究的一个重要课题。在新世纪里,易经文献整理如何发展和继续,这是从事易学研究的文献学者需要首先思考的问题。文章针对学科的走向问题,提出了一系列个人的见解和主张。     

Predicting positive mental health in internally displaced persons in Indonesia: the roles of economic improvement and exposure to violent conflict

Positive mental health, rather than just the absence of mental illness, is rarely investigated among the internally displaced persons (IDPs) affected by violent conflict in low-income countries. The purpose of this study was to investigate a model that could explain the interrelationship between factors contributing to positive mental health in displaced populations. In a longitudinal study we examine poverty, exposure to traumatic events and the change of material well-being after one year. We collected data in two consecutive years (2005 and 2006) from a community-based sample of IDPs in Ambon, Indonesia, through face-to-face structured interviews with consenting adults. Participants of this study were IDPs lived in Ambon during the violent conflict period. We interviewed 471 IDPs in the first year and reinterviewed 399 (85%) of the same subjects in the second year. The IDPs possessed good sense of coherence and subjective well-being. Our final model, which was generated by the use of structural equation modeling, fits the data well (χ² = 52.51, df = 45, p = .21, CFI = .99, RMSEA = .019). Exposure to violent conflict had a negative impact on IDPs’ mental health initially and better economic conditions improved it (r = ?.30 and .29 respectively). Mental health status one year previously was a strong predictor of future mental health, followed by individual economic growth in the past year (r = .43 and .29 respectively). On a group level the IDPs were resilient and adaptive to survive in adverse living conditions after devastating violent conflict, and the economic improvement contributed to it.