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.     

‘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.     

Realising the Right to Health for Young People in South Africa—Some Reflections

Abstract

The right to health is enshrined in the South African Constitution as well as a range of international and regional human rights treaties which South Africa accepts. Yet empirical data reveals some of the challenges faced by South African youth—childhood diseases, HIV/AIDS and such like. There are evidently challenges realising the right to health in practice. Nevertheless, South African courts have led the international field in recognising the justiciability of economic and social rights such as the right to health. Having reviewed the applicable laws and jurisprudence, the paper will conclude that a more holistic human rights-based approach offers perhaps the best way forward.     

Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. Yet it occasionally seems morally permissible to carry out non-consensual medical interventions on competent individuals for the purpose of infectious disease control (IDC). We describe two different moral frameworks that have been invoked in support of non-consensual IDC interventions and identify five desiderata that might be used to guide assessments of the moral permissibility of such interventions on either kind of fundamental justification. We then consider what these desiderata imply for the justifiability of carrying out non-consensual medical interventions that are designed to facilitate rehabilitation amongst serious criminal offenders. We argue that these desiderata suggest that a plausible case can be made in favor of such interventions.     

ICF脑卒中核心分类组合功能的图形建模研究

目的依据《国际功能、残疾和健康分类(ICF)》脑卒中核心组合,探讨脑卒中相关功能类目之间的关系,绘制ICF脑卒中核心分类组合的功能地形图,为脑卒中的伤残评定提供科学理论依据。方法收集106例脑卒中被鉴定人样本,采用"最小的绝对缩减和变量选择算子",研究脑卒中ICF核心组合功能的59项类目变量之间的条件依存关系,并用图形建模分析类目之间的内在联系,绘制功能地形图。结果 59项类目之间的相互联系构成了功能地形图,b340、b735、b175和b152因关联性较高而居于地形图的中心位置。结论脑卒中功能地形图可以揭示ICF功能类目之间复杂的关系结构及关联程度。可以为应用ICF进行脑卒中的伤残评定提供科学理论依据。