各利益相关者在医院与社区双向转诊合作中的责任与机制简

针对目前双向转诊中信息不能共享、药品获得和费用报销障碍、社区人力服务水平相对较差等问题,从双向转诊中各利益相关者角度分析在双向转诊实施过程中政府、医疗机构（医院与社区卫生服务机构）、患者与家属各自应当承担的责任,提出相应的措施及改进机制。     

论强制医疗启动程序决定主体

强制医疗制度是国家医疗保健制度的有机组成部分,强制医疗有广义与狭义之分。狭义的强制医疗,如实施危害行为的精神病患者、甲类传染病患者等;广义的强制医疗,包括预防接种、指定医保单位就医等。强制医疗程序启动的决定主体必须是国家赋予相应权力的机关,其他任何单位不具有这样的权力,因而无权决定强制医疗程序启动。强制医疗主体的确定取决于强制医疗对象的危害程度、广度及时间等因素。     

Bringing the Revolution to the Countryside: Rural Health Programmes as State‐Building in Post‐1952 Bolivia

Bolivia's Movimiento Nacionalista Revolucionario (Revolutionary Nationalist Movement, MNR) took power in April 1952 via a popular social revolution. After 1952, the party implemented state‐sponsored modernisation projects, including extending rural public health programmes. The MNR used health programmes to change rural practices, cultivate political loyalty, and expand the state's political power. Yet rural indigenous communities were hardly passive recipients of these programmes. These communities often requested government services, and they borrowed the MNR's own political rhetoric to position themselves as worthy of state attention. Public health programmes increased access to rural health care, but they also allowed state officials and rural communities to negotiate the MNR's authority.     

Negotiating democracy with authoritarian regimes. EU democracy promotion in North Africa

ABSTRACT

In order to better understand the dynamics of international cooperation on democracy promotion with authoritarian regimes, this article looks into the processes and results of negotiations on democracy (promotion) between the European Union (EU) and two of its North African neighbours (Morocco, Tunisia) in the decade leading up to the Arab uprisings. Asking if, how, and to what effect the EU and its Mediterranean partners have negotiated issues related to democracy promotion, it analyses official documents issued on the occasion of their respective association council meetings in 2000-2010. It shows that partners have indeed addressed these issues since the early 2000s, however, without engaging in substantive exchanges. Most of the time, conflicts have been neither directly addressed nor resolved. Where there are traces of actual negotiations leading to an agreement, these are clearly based on a logic of bargaining rather than arguing. These findings challenge the picture of harmony and cooperation between the EU and Morocco. Furthermore, they point to the low quality of these exchanges which reinforces the dilemma of international democracy promotion in cooperation with authoritarian regimes.     

‘A Sick,Weak, and Ignorant People’: Public Health Education and Prevention in Rural Colombia, 1930–1940

This article analyses Salud y Sanidad (Health and Sanitation), a government journal edited in 1930s Colombia. It examines the state's model of public health, which proposed education and prevention as strategies to guarantee the success of its programmes. It argues that despite the journal's more progressive approaches, editors and contributors reproduced stereotypes about Colombia's rural inhabitants that contradicted state rhetoric and showed the limits of public health models that do not address the underlying social inequities that drive the propagation of poverty and disease in rural areas, and that ultimately continued to blame victims for their illness and misfortune     

‘Monsters don’t bother me anymore’ forensic mental health service users’ experiences of acceptance and commitment therapy for psychosis

Acceptance and Commitment Therapy for psychosis (ACTp) is an approach that aims to change the relationship an individual with psychosis has with difficult thoughts, emotions and experiences. It promotes the use of acceptance, defusion, mindfulness and focussing on valued outcomes as opposed to struggling with psychotic experiences. This service evaluation project explored service users’ experiences and meanings of ACTp within a medium secure mental health service. Thematic analysis was used to analyse interviews with 10 male service users. Four main themes emerged from the data: ‘Recovery’, ‘Insight’, ‘Developing Skills’ and ‘Accessibility’. Overall, service users viewed their experience of ACTp positively and identified encouraging therapeutic outcomes. These findings suggest that ACTp is an approach that should be considered a therapeutic option within forensic mental health contexts. These outcomes were compared with previous research findings. Limitations of the study, clinical implications and ideas for future research have been discussed.     

Tarasoff in Missouri: The jurisprudence of a mental health provider's duty to warn and protect non-patients of potential risks from patients

In 1976, the Supreme Court of California issued its well-known Tarasoff Principle. From this principle, other courts found a duty to warn, and some found more than just a duty to warn, a duty to protect. As courts in other states adopted a version of the Tarasoff Principle, they issued a wide variety of third-party liability rules. In light of the dynamic, everchanging Tarasoff jurisprudence in the United States and recent relevant appellate court opinion in Missouri, a timely updated summary and update of Tarasoff-related jurisprudence in Missouri is warranted. In the present analysis, we compiled the four appellate court decisions that pertained to the questions of Tarasoff-like third-party liability in the State of Missouri: Sherrill v. Wilson (1983), Matt v. Burrell (1995), Bradley v. Ray (1995), and Virgin v. Hopewell (2001). We reviewed all legal measures for clinicians to protect nonpatients in Missouri, not just those that relate to protecting nonpatients from violence as in a Tarasof-like scenario. Thus, this paper concisely provides a compendium of such options and allows for a meaningful comparison of which legal, protective measures are mandatory and which are permissive, thereby evoking the question of whether measures of protecting nonpatients from a patient's violent acts ought to be mandatory duties or permissive application of professional judgment.     

Conclusion: Mental health and legal responses to the adolescent mental health crisis: Raising the bar on best interests and promoting family connectedness in divorcing families

We are currently facing an unprecedented increase in adolescent mental health problems resulting in alarmingly high levels of depression, anxiety, and suicidality. Significant mental health problems among youth pose unique challenges to families in the process of separation and divorce, as well as to family law professionals across all disciplines. The current adolescent mental health crisis calls for new ways of approaching our work with high conflict families to promote family connectedness and shift away from adversarial approaches that may exacerbate conflict and further destabilize families. As a conclusion to the special issue on adolescent mental health needs, the authors make multidisciplinary best practices recommendations and advocate for systems level changes in recognition of the needs of youth in crisis at this pivotal developmental stage.     

Development of an Index of Subsidized Housing Availability and its Relationship to Housing Insecurity

Housing insecurity is a known threat to child health understanding predictors of housing insecurity can help inform policies to protect the health of young children in low-income households. This study sheds light on the relationship between housing insecurity and availability of housing that is affordable to low-income households.

We developed a county-level index of availability of subsidized housing needed to meet the demand of low-income households. Our results estimate that if subsidized units are made available to an additional 5% of the eligible population, the odds of overcrowding decrease by 26% and the odds of families making multiple moves decrease by 31%. Both of these are known predictors of poor child health outcomes. Thus, these results suggest that state and federal investments in expanding the stock of subsidized housing could reduce housing insecurity and thereby also improve the health and well-being of young children, including their families' food security status.