Working with Southeast Asian refugees

Increasingly, refugees from Laos, Cambodia and Viet Nam are coming to Mental Health Centers for help. For the Indo Chinese patient, an emotional problem may have a very different meaning—a meaning not immediately obvious to the Western mind. The emotionally troubled individual may feel that he or she is being punished, and that confiding to a psychotherapist is shaming or betraying the family and the ancestors. Consequently, emotional problems may be converted to somatic complaints, particularly of the respiratory and gastrointestinal variety. Psychotherapy with the refugee involves different techniques as well as different meanings. Confrontation and exploration, for example, may be misunderstood by the patient. In working with the Indo Chinese refugee it is recommended that the clinician be flexible, persevering, and open minded.     

Conservatism of the Accident Sequence Evaluation Program HRA Procedure

This paper presents a limited assessment of the conservatism of the Accident Sequence Evaluation Program (ASEP) human reliability analysis (HRA) procedure described in NUREG/CR-4772. The data for this study are derived from simulator examination reports from the NRC requalification examination cycle for nuclear power plant operators. The ASEP procedure was used to estimate human error probability (HEP) values for critical tasks, and the HEP results were compared with the failure rates observed in the examinations. The ASEP procedure was applied by PNNL operator license examiners who supplemented the limited information in the examination reports with expert judgment based upon their extensive simulator examination experience. Comparison of the average of the ASEP HEP values with the fraction of the population actually failed and demonstrated that the ASEP HEP values are larger (conservative) by a statistically significant average factor of two. Partitioning of tasks into subgroups based on the ASEP HEP values and comparison of the subgroup average ASEP HEP values with observed subgroup failure rates showed little or no conservatism for small ASEP HEP values, but considerable conservatism for larger ASEP HEP values.     

Governance in Public-Private Community Health Partnerships: A Survey of the Community Care Network SM Demonstration Sites

This review of the governance practices of twenty-five public-private partnerships involved in addressing a broad range of community health needs shows that governance in public-private community partnerships departs significantly from traditional notions of institutional governance. Governance structures and degrees of progress toward governance goals vary widely and appear to be systematically related to the organization, composition, location, and activity of each partnership.     

Self-Medication, Traumatic Reenactment, and Somatic Expression in Bulimic and Self-Mutilating Behavior

A psychoanalytic framework provided direction for research on the association between binge-purging (bulimic) and self-mutilating behaviors, comparing them for similarities and differences. The similarities in the multiple functions and psychosomatic processes served by these behaviors are presented, as well as the phenomenon of symptom substitution. Both behaviors tend to be practiced by those with severe personality and dissociative disorders and post-traumatic stress disorder. Both serve ego-compensatory needs in the absence of the adequate ability to regulate and modulate emotions, moods, and tensions. They may serve as compensatory attempts to differentiate self and object, define and differentiate body boundaries, master severe childhood trauma by means of psychophysiological addictive reenactments, and to express emotion.     

You Must Be Joking: The Sociological Critique of Humour and Comic Media

Recent work in the sociological critique of humour and comic media has challenged the notion that humour is an absolute good. In this article, we review some of the most interesting work that takes humour seriously and addresses the difficult topic of whether there are ethical limits to humour and media comedy. We outline three main reasons for taking humour seriously and review some of the ways in which humour has been studied sociologically through a consideration of how British 'alternative' comedy directed the work of those interested in the limits of humour in relation to gender, race and ethnicity. We also summarise some of the most controversial examples of contemporary media comedy – the comedic performances and personae of Sacha Baron Cohen (Ali G and Borat) and the Danish cartoons of the Holy Prophet Muhammad – in order to illustrate the importance of the critical analysis of humour and how the ethics of humour can be applied to comic media.     

The Process of Cognitive Liberation: Cultural Synapses,Links, and Frame Contradictions in the U.S.-Central America Peace Movement*

Based upon qualitative interviews with thirty-two Central American peace activists, this article elaborates the process of “cognitive liberation” through the application of frame analysis. In addition, I seek to explain the diffusion of this social-psychological state from Central to North America. Attention is given to the role of the church as a common cultural link that functioned as a micro-mobilizing context, which provided missionaries who served as “meso-mobilizing actors.” The term frame contradictions is introduced to specify the condition in which irreconcilable differences between a movement's frame and its opponent's frame are exposed, thereby facilitating frame adoption. I conclude that some type of cultural link is necessary for the development of a common frame that can integrate groups cross-nationally and that can provide agents of mobilization to serve as a synapse through which frames can be transmitted from one country to another.     

Personalization of Mail Surveys for General Public and Populations with a Group Identity: Results from Nine Studies*

Abstract The effect of personalization on mail survey response rates was examined in nine studies that included 17 comparisons under several research conditions. A study of this variable across multiple experiments in five agricultural experiment stations was undertaken because of conflicting results from previous research and from concern that the effectiveness of personalization might have decreased over time. Results show that, while response to general public surveys appeared to increase modestly across all treatment groups, there was no positive effect for populations in which a group identity (e.g., Dear Oregon Gardner or Dear ATV Owner) is employed to address respondents in cover letters. Personalization appears to remain useful for improving response in surveys of the general public.     

Providing mental health services to older people living in rural communities

Rural dwelling elders who experience mental health problems often have difficulty finding help since rural communities often lack adequate mental health service providers. This paper reports on the initial phase of a 5-year, interdisciplinary clinical research study that is testing the effectiveness of providing a home delivered, therapeutic psychosocial intervention, aimed at improving the emotional wellbeing and the quality of life of medically frail elders who live in rural communities. In the early phases of this study, the clinical research team encountered a number of interesting and often unanticipated challenges as it attempted to recruit study participants and provide services to them. In this article, we examine these challenges and share what we have learned so far about providing mental health services to elderly persons living in rural environments.