能挽救生命的医学突破

新生代治疗方法已加入到与中风、癌症和心脏病作斗争的行列。除了小时侯摘除过扁桃体之外,63岁的霍华德·库比兹从未进过医院。因此,1998年6月8日,当他中风、身体右半边麻痹时,他唯一的恐惧就是,正如他所了解的,生活就此结束了。他已经想象自己被束缚在轮椅上或是在疗养院里度过余生。     

Generalizability of Gottman and Colleagues' Affective Process Models of Couples' Relationship Outcomes

The generalizability of Gottman et al's. (1998) affective process models was examined using a community-based sample of 85 married or cohabiting couples with at-risk backgrounds. Predictive associations between affective processes assessed at about age 21 years and relationship status and satisfaction approximately 2.5 years later were examined. The major findings of Gottman et al. failed to replicate. In particular, men's rejection of their partners' influence, the lack of men's deescalation of partners' negative affect, and women's negative start up were not predictive of relationship status. Further, differences in affective processes were found when comparing discussion sessions of the men's versus the women's chosen topics. The findings suggested that the validity and utility of the affective process models need further investigation.     

Judicial Decision Making and International Tribunals: Assessing the Impact of Individual,National, and International Factors*

Objective. The objective of this article is to explain judicial decision making at the International Criminal Tribunal for the Former Yugoslavia by analyzing the impact of individual, national, and international factors. Methods. We use regression and probit analysis of data on the verdicts and sentences handed down by the judges. Results. We find that international factors best explain judicial decision making, especially regarding sentencing. Conclusions. International tribunals and courts are becoming increasingly important and prevalent and it is critical that scholars better understand how their judges make decisions.     

Race Differences in Sexual Behavior and Their Demographic Implications

Differences between blacks and whites in sexual behavior posited in Rushton's theory of r-K race differences were examined in the United States in an analysis of the annual surveys of the National Opinion Research Center for 1990–1996. This data set was analysed for black-white differences in numbers of sexual partners during the last 5 years and for frequency of sexual intercourse. The general pattern of the results was for blacks to report more sexual partners than whites and for black males to report greater frequency of sexual intercourse, consistent with Rushton's theory. This result has implications for the control of the AIDS epidemic and for the demographic transition among blacks.     

Exiting the Drug-Addict Role: Variations by Race and Gender

Our paper explores race and gender variations in the processes of exiting a “drug-addict role” and in creating a “recovering-addict role” within the ideological constraints of 12-Step programs. Our method is qualitative and features in-depth interviewing with 45 currently abstinent drug addicts from the 12-Step programs of Alcoholics Anonymous (A.A.) and Narcotics Anonymous (N.A.) in the Washington, D.C., Metropolitan Area as well as a residential and out-patient treatment program in mid-Michigan. Our respondents' exit processes typically began with doubts about the drug addict role followed by an often long and dynamic period of seeking alternatives to it without giving up drugs and alcohol completely. In some cases, however, participation in a new role initiated doubts about an existing one. Contrary to extant research, turning points or epiphanic moments in existing roles were not always identified. Most importantly, however, we found many differences by race and gender in what comprised the exit process. Gender socialization, cultural diversity, and the history of race relations in the United States help to explain this diversity.     

Overcoming medication refusal using a patient-centered approach

The refusal of psychotropic medication is a challenge faced by many healthcare providers when treating patients with mental illness. Controversy surrounds medication refusal because some mental health professionals believe that psychiatric patients should be forced to take medications for the safety of the general public, while patients are often acutely aware of potential lifelong adverse side effects and are sometimes reluctant to comply. The proposed alternative to this problem begins with developing the patient-provider relationship through a patient-centered approach. This approach emphasizes the individual needs of patients and creates opportunities for input from patients about their care, which helps form relationships of mutual trust and respect between patients and providers. This article explores the literature to: (1) understand some of the challenges and controversies involved in patient medication refusal from a clinical and societal level; (2) identify some issues in a patient-centered approach; and (3) make some brief clinical and policy recommendations that might help to bring about an increase in the use of patient-centered care. Hopefully, as efforts are made toward a patient-centered approach, increased psychotropic medication adherence and decreased medication coercion will result as providers listen and act upon the needs of their patients.