NATURAL HEALTH DISCOURSES AND THE THERAPEUTIC PRODUCTION OF CONSUMER RESISTANCE

Social critics of the natural health movement charge that it indoctrinates consumers in a therapeutic consumerist ideology. This "dominated consumer" thesis ignores that socially situated individuals must negotiate a plethora of institutionally specific power structures aiming to classify and govern their identities. Accordingly, resistance toward specific institutional constructions of identity can be produced through marketplace ideologies. I explore this understudied ideological effect by analyzing the narratives of women who are using natural health alternatives to resist their ascribed medico-administrative identities. Natural health's therapeutic ideology enables these women to contest the degenerative implications of their medical diagnoses and, conversely, to reconstruct their chronic illnesses as an opportunity for discovering their inner regenerative potential and expanding their spiritual horizons. This analysis has implications for prior studies suggesting that resistance toward the technocratic and bureaucratic aspects of conventional medicine exemplifies a Foucauldian "care of the self." I argue that a postmodern adaptation of Foucauldian theory is needed to address the complex interrelationships among the care of the self, medical consumerism, and the therapeutic ideology of the natural health marketplace.     

Marginal and association regression models for longitudinal binary data with drop‐outs: A likelihood‐based approach

Longitudinal data often contain missing observations, and it is in general difficult to justify particular missing data mechanisms, whether random or not, that may be hard to distinguish. The authors describe a likelihood‐based approach to estimating both the mean response and association parameters for longitudinal binary data with drop‐outs. They specify marginal and dependence structures as regression models which link the responses to the covariates. They illustrate their approach using a data set from the Waterloo Smoking Prevention Project They also report the results of simulation studies carried out to assess the performance of their technique under various circumstances.     

When Being Different Is Detrimental: Solo Status and the Performance of Women and Racial Minorities

Individuals experience solo status when they are the only members of their social category (e.g., gender or race) present in an otherwise homogenous group. Field studies and surveys indicate that members of socially disadvantaged groups, such as women and racial minorities, have more negative experiences as solos than do members of privileged groups, such as Whites and males (Kanter, 1977; Niemann & Dovidio, 1998). In this article, we review research showing that the public performance of women and African-Americans is more debilitated by solo status than that of Whites and males. We also show that this effect is exacerbated when negative stereotypes about the performer's social group seem relevant to their performance, and we discuss the contributing roles of lowered performance expectancies and feelings of group representativeness. We discuss how findings from social psychological research can be applied towards the goal of reducing the decrements typically associated with being the only member, or one of few members, of one's race and/or gender in the environment.     

Border Crossings and Diasporic Identities: Media Use and Leisure Practices of an Ethnic Minority

The diaspora of peoples whose origins were in the Indian subcontinent (South Asia) and who are now living in Western countries (especially the U.S. and UK) provides an interesting example of processes of negotiation of new hybrid cultures and identities, using new technologies, such as the Internet, and older technologies like the video player, cable or satellite television, radio, and telephone. These developments may require a revision of the classic sociological picture of assimilation as a zero sum model of acculturation, in which the acculturation of immigrants and their children involves the gradual replacement of their ethnic culture by that of the culture of the host nation. The electronic media, in the context of policies of multiculturalism, may lead to an accentuation of religio-ethnic differences. Contrary to previous assumptions, middle-class immigrants may be more inclined to resist cultural assimilation than their lower-class counterparts.     

The place of ego building work in psychotherapy with children

Ego building is essentially a name given to a variety of interventions used to support an ego hampered by regression or deviation. The term has its roots in the concept of ego support but evolved specifically as a technical term in contemporary ego psychology closely connected with the developmental theory of separation individuation. Using four vignettes of psychotherapy work with children all of whom suffered from unresolved conflicts and developmental interferences from the separation-individuation process, an attempt is made to illustrate the technical place of ego building in psychotherapy with children. It is suggested that the use of ego building, particularly verbalizing adaptive aims facilitates an alliance, supports a safety feeling and positive self-esteem. This contributes to providing a treatment experience that reduces over-stimulation and anxiety and frees the expression and understanding of aggression which ultimately promotes separation-individuation.in private practice.This paper was presented at the Conference on the Continuing Evolution of Psychoanalytic Thought: Infancy to Adulthood, N.Y.C., Nov. 1990., sponsored by the Committee on Psychoanalysis of the National Federation of Societies for Clinical Social Work.     

A Sparse Implementation of the Average Information Algorithm for Factor Analytic and Reduced Rank Variance Models

Factor analytic variance models have been widely considered for the analysis of multivariate data particularly in the psychometrics area. Recently Smith, Cullis & Thompson (2001) have considered their use in the analysis of multi‐environment data arising from plant improvement programs. For these data, the size of the problem and the complexity of the variance models chosen to account for spatial heterogeneity within trials implies that standard algorithms for fitting factor analytic models can be computationally expensive. This paper presents a sparse implementation of the average information algorithm (Gilmour, Thompson & Cullis, 1995) for fitting factor analytic and reduced rank variance models.     

A Process for Incorporating Comparative Risk into Environmental Policymaking in Louisiana

The goal of Louisiana's 1990–1991 comparative risk project, also called the Louisiana Environmental Action Plan (LEAP), was to incorporate risk assessment into state environmental planning and policymaking. Scientists, government officials, and citizens were brought together to estimate the relative risk to human health, natural resources, and quality of life posed by 33 selected environmental issues. The issues were then ranked according to their relative estimated risks. It was hoped that this ranking of "comparative risks" would enable state policymakers to target the most important environmental problems and allocate scarce public resources more rationally and efficiently. As a result of the project, the governor issued an Executive Order forming a permanent Public Advisory Committee to continue this type of comparative risk assessment in Louisiana.     

From quality assurance to continuous quality improvement

To change from punitive and legalistic QA to positive and productive CQI, both attitudes and methods must change. This is a difficult challenge, but potential rewards for both the organization and its individual members suggest that the effort is worthwhile and deserves high priority. Members of the executive/management team will likely turn to physician executives for guidance on how to proceed.