Cultural Attunement in Therapy With Mexican‐Heritage Couples: A Grounded Theory Analysis of Client and Therapist Experience

There is a need for culturally attuned approaches for couple therapy with Mexican/Mexican‐Americans. This qualitative grounded theory study utilized interviews with 11 client couples of Mexican heritage and 14 marital and family therapists to shed light on how Latino and non‐Latino therapists co‐construct positive experiences of cultural attunement with Mexican and Mexican‐American couple clients. Analysis identified a model of cultural connection through personal engagement with four interrelated phases: (a) mutual invitation, (b) shared engagement, (c) expanding personal connection, and (d) creating cultural connections. Clients in this study valued professionalism and expertise of the therapist, but felt attuned to and respected when therapists demonstrated humility, shared personal stories and emotion, and engaged in a collaborative process.     

Teaching Manual Signs to Adults With Mental Retardation Using Matching-to-Sample Procedures and Stimulus Equivalence

The objective of this study was to teach manual signs through an automated matching-to-sample procedure and to test for the emergence of new conditional relations and imitative behaviors. Seven adults with mild to severe mental retardation participated. Four were also hearing impaired. Relations between manual signs (set A) and pictures (set B) were initially taught, followed by the training of corresponding printed words (set C) and pictures (set B). Further presentations of conditional discriminations tested for the emergence of AC, followed by tests for the emergence of imitative signing behavior (D) in the presence of either pictures (B) or printed words (C). Each stimulus set was comprised of 9 elements. The stimuli were still pictures, printed words, and dynamic presentations of manual signs. A pretest was conducted to determine which signs the participants could make pre-experimentally. Teaching was arranged in a multiple baseline design across 3 groups of 3 words each. The purpose of the present study was to determine whether participants would emit manual signs in expressive signs tests as a result of observation (video modeling) during match-to-sample training in the absence of explicit training. Five of the 7 subjects passed tests of emergence and emitted at least 50% of the signs. Two were hearing impaired with signing experience, and 3 were not hearing impaired and had no signing experience. Thus, observation of video recorded manual signs in a matching-to-sample training procedure was effective at establishing some signs by adults with mental retardation.     

The European Court of Justice and the free movement of patients in the European Union

At present, health policy in the European Union (EU) is being developed in an extremely disconnected fashion. EU member States independently develop their own health systems, based on the goals they wish to pursue, without really considering consistency with European Community (EC) law. The impact of European integration is, in turn, mainly indirect and has emerged from European Court of Justice (ECJ) rulings. These rulings have arisen either from considerations in other sectors or through the process of addressing particular issues within single cases, leaving major issues of applicability unresolved. The evolving issue of free movement of patients is instructive. While not completely outlawing the use of a prior authorization system, recent ECJ rulings have radically restricted member States' discretion to determine their own policies by requiring that their decisions be necessary, proportional and based on objective and non-discriminatory criteria. By linking EEC Regulation 1408/71, on which cover for healthcare abroad has been traditionally based, with the free provision of services, the ECJ seems to have created difficulties and important uncertainties for the system of coordination of social security schemes.     

Asymptotic Behavior of the Hazard Rate Kernel Estimator Under Truncated and Censored Data

In this article, we give the asymptotic mean integrated squared error and the mean squared error for the kernel estimator of the hazard rate from truncated and censored data. Martingale techniques and combinatory calculus are used to obtain these results. A probability bound and the optimal bandwidth choice are also given.