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PubMed1975

[Psychodynamics of ideological democracy].

In order to understand "ideological democracy" and its consecuences for therapy it is important to study the ideology of group members from the psychodynamic standpoint. Ideology is understood as a system of rules to interpret reality, although from a theoretical point of view, we contend reality itself is free from ideology. Ideology is thus defined as a cognitive system, stemming from emotional matrices of the psychosexual development of personality. The understanding of how the members of the Therapeutic Community attain "ideological democracy" is, to our mind, essential in order to be able to attain therapeutic goals. After a brief introduction the paper deals with ideology and its relationship with different personality structures: hysteric, phobic, psychopatic, depressive, paranoid and schizoid. Several common mechanisms for building ideology are set forth. The final conclusion is that such an analysis helps to ascertain the best strategies for community therapy.

Colombia↗
PubMed2001

Democracy and the governance of uncertainty. The case of agricultural gene technologies.

The use of genetically modified organisms (GMOs) in agriculture and food production is the object of an intense and divisive debate. Drawing on a study on the public perception of agricultural gene technologies carried out in five European countries, the article deals with the policy aspects of the issue, and more precisely on the relation between institutions, experts and the public in a context of deep uncertainty. A theoretical framework is developed and compared with the study findings, suggesting that issues like the GMOs one represent a strong case for a more participatory policy-making. My conclusions suggest a style of governance based on the principles of deliberative democracy, as a suitable approach to the confrontation of different viewpoints and forms of knowledge. This appears to be the best way to improve the overall quality of policy-making: in this I include its legitimacy, the degree of public trust, and also the actual quality of its products. Strengthening the role of the public sphere seems more effective than simply increasing direct decision-making by the populace, and it offers an alternative to the 'elitist' solutions to the crisis of representative democracy.

Agriculture↗
PubMed1996

Pharmaceutical services in an Army field hospital in Haiti during Operation Uphold Democracy.

The pharmaceutical services provided by an Army field hospital in Haiti during Operation Uphold Democracy are described. In January 1995, 155 soldiers of the 47th Field Hospital from Ft. Sill, Oklahoma, were deployed to Haiti to provide medical care for 2400 U.S. troops and 7000 multinational troops and police officers. The pharmacy staff (one pharmacist and two technicians) provided patient counseling, drug information, staff consultation, and clinical support to the intensive and intermediate care wards and emergency medical tent of the field hospital. Other responsibilities were providing nonprescription drugs to outpatients, interpreting and evaluating drug orders, participating in drug selection, and ordering supplies. A 30- to 60-day drug supply was maintained. The formulary was designed by the pharmacist and an internist and was based on the mission requirements and conditions in Haiti. Of the 10 oral medications most commonly dispensed to outpatients, 6 were antibacterials and 1 was an antimalarial. An average of two patients were admitted to the hospital daily. Some 240 inpatients were recorded in the pharmacy computer during the hospital's six-month deployment, and more than 5000 were treated in the emergency tent. The pharmacy service of the 47th Field Hospital met the challenge of supporting U.S. and multinational troops in Haiti during Operation Uphold Democracy.

Haiti↗
PubMed2002

The Families and Democracy Project.

The Families and Democracy Project moves family therapists and other professionals into the community via a critique of traditional provider/consumer models of family services, a set of principles about the civic engagement of families in partnership with professionals, and a set of public practices for working on community problems. We describe the Families and Democracy model and three specific projects. We distinguish the model from traditional hierarchical and collaborative models of working with families. And we discuss lessons we have learned, and our plans to take this work to its next developmental stage.

Adolescent↗
PubMed2004

Mediums and messages: an argument against biotechnical enhancement of soldiers in the armies of liberal democracies.

Assuming that one believes that individuals and states can morally defend values, beliefs, and institutions with force (in short, that just wars are morally possible), one logically wants just combatants to possess the physical, mental, and spiritual capacities that will enable them to win the war. On the other hand, being a just combatant in a just war does not morally entitle that combatant to do anything to win that war. The moral requirement for just combatants to fight justly is codified in international law of war and in state-specific legal documents such as the United States Uniform Code of Military Justice. While it is almost unequivocally clear to soldiers and civilians who soldiers cannot harm in the performance of their duties, and why these people are exempt from harm, it is less clear what the state itself (assuming throughout the discussion that the state is a just combatant in a just war) can morally do to its own soldiers to enhance their chances of victory: can the state do anything to soldiers to give them an advantage on the field of battle? For United States soldiers and their counterparts in most Western liberal democracies, the answer is obviously no. Deeply embedded social and cultural norms in Western democracies mandate that the state set and enforce rigid lines which drill sergeants and earnest commanders cannot cross, even in the name of combat readiness, grounding these norms in notion of basic rights appealed to in the U.S. Constitution. In this essay, I argue against some types of drug-induced internal biotechnical enhancement of soldiers on the grounds that, in the present state of technology, it is not reasonable to suppose that the military can perform such enhancement operations on soldiers without causing irrevocable psychological damage that would certainly and unjustifiably alienate the soldiers from the very society they serve.

Biomedical Enhancement↗
PubMed2004

Health sector policy in the first decade of Nepal's multiparty democracy. Does clear enunciation of health priorities matter?

Nepal experienced a significant political regime shift in 1990 from the partyless Panchyat system to the present multiparty form of democracy. While political instability existed in the decade of the 1990s, reflected in the approximately one government per year, there had been continued enunciation of health policy priorities toward the rural sector, as reflected in the Nepal National Health Policy, 1991 (NHP (1991)) and subsequent plans. The objective of the paper is to assess whether clear enunciation of health priorities have translated into beneficial health outcomes, reflected in reduction of the child death rate, child morality rate, infant mortality rate and increase in the life expectancy rate. This question is assessed empirically over the 10-year period of fiscal year 1989/1990 to 1999/2000 using mainly secondary data published by His Majesty's Government of Nepal (HMG/N), through the perspectives of input-output model and extension of health services, along with an indicative regression of a Nepalese health production function. The results (i.e. empirical observations) suggest that while there have been clear enunciation of health priorities, there have not been significant positive effects on health sector outcomes. The paper ends with a number of recommendations and concludes with the necessity for effective and appropriate implementation.

Adult↗
PubMed2004

Ten years of democracy in South Africa: documenting transformation in reproductive health policy and status.

The advent of democracy in South Africa in 1994 created a unique opportunity for new lows and policies to be passed. Today, a decade later, South African reproductive health policies and the laws that underwrite them are among the most progressive and comprehensive in the world in terms of the recognition that they give to human rights, including sexual and reproductive rights. This paper documents the changes in health policy and services that have occurred, focusing particularly on key areas of sexual and reproductive health: contraception, maternal health, termination of pregnancy, cervical and breast cancer, gender-based and sexual violence, HIV/AIDS and sexually transmitted infections and infertility. Despite important advances, significant changes in women's reproductive health status are difficult to discern, given the relatively short period of time and the multitude of complex factors that influence health, especially inequalities in socio-economic and gender status. Gaps remain in the implementation of reproductive health policies and in service delivery that need to be addressed in order for meaningful improvements in women's reproductive health status to be achieved. Civil society has played a major role in securing these legislative and policy changes, and health activist groups continue to pressure the government to introduce further changes in policy and service delivery, especially in the area of HIV/AIDS.

Democracy↗
PubMed1995

States facing interests: struggles over health care policy in advanced, industrial democracies.

Given alarming fiscal imperatives, states and interests in all advanced industrial democracies have struggled over health care policy. I explore the interface between state autonomy in health care policy and the political mobilization of provider interests, especially physicians. Evidence from Germany, Japan, Canada, and Great Britain suggests that, longitudinally, policy makers everywhere have tried to increase state autonomy in health care, and this has generally triumphed over even effectively mobilized providers. The countries that have most successfully restrained the growth of health care expenditures--while still providing ready access to relatively high-quality care--are those where states have most actively restrained both demand- and supply-side system interests in policy making. In each country, states have increasingly articulated their own greater capacities in health care policy, pushed to do so by the imperatives, especially fiscal, embedded in the policy domain.

Attitude of Health Personnel↗
PubMedDate not supplied

[Power relations and democracy in health councils in Brazil: a case study].

BACKGROUND: Social participation is fundamental for the consolidation of the Brazilian Health Reform, with the aim of promoting equity, universality and democratization of access to health, and the health councils are vital forums for its concretization. However, the authoritarian culture of our institutions makes effective participation in these organizations difficult. The objective of this work was to analyze the power relations which permeate the practices of a health council, seeking to understand discourse as a builder of participation in health. METHODS: A qualitative case study in a municipal health council in a Brazilian town. The discourse analysis was carried out on the minutes of two management terms, legal documents, interviews and observation during meetings. RESULTS: The quantitative presence of the user representatives does not correspond to the quality of their participation. The governmental sector uses most of the speaking turns, establishing monological relations, based on the a lack of symmetry determined by level of education, professional training, social status of the councilors and the relations of knowledge and power present in the health institutions. We identify resistances coming from the user sectors and the health professionals. However, these are scattered, fragile and not very important. CONCLUSIONS: The current practices that exist can, contrarily, go against democracy, for which is necessary to invest in the empowerment of councilors and users in the day-to-day reality of health care.

Brazil↗
PubMed1981

Democracy, authoritarianism, and health in Argentina.

The democracy-participation-better health versus authoritarianism-repression-worse health polarity is illustrated by the case of health policy in Argentina. At the turn of the century, Argentina's health levels were among the highest in the world. The subsequent deterioration can be correlated with disruptions of the country's democratic process. The participation of the military in Argentinian political life has produced a lowering of the standard of living of the majority of the population, with a consequent increase in mortality and morbidity, and the appearance of elitist, commodity-centered health policies. the anti-health policies of the military are contrasted with those pursued by democratically elected Argentinian governments, as well as the principles set forth in recent declarations of human rights.

Argentina↗
PubMed1989

The role of union democracy in the struggle for workers' health in Mexico.

In this article, the author analyzes the struggle for workers' health in Mexico, emphasizing the importance of the general and specific political context. In an overview of the legislation on industrial health and safety, the state institutions involved in the issue, and the characteristics of union organization in Mexico, the author shows that the limited activities related to workers' health have more to do with the relative political weakness of the Mexican working class than with the formal structures of legislation, state institutions, and unions. The second part of the article deals with the four most important struggles for health and safety in Mexico during the last ten years, which show some similarities. These struggles are consistently linked to processes of union democratization and tend to decline when union democracy is lost. The strategies of the companies show a common pattern: removing health issues from collective bargaining and putting them in the hands of state institutions. When workers have opposed this solution, management has used selective repression to solve the conflict. The state institutions subordinate their position to the companies' by postponing action or by doing a technically poor job. Changing the existing situation involves the social legitimation of the workers' health issue, since this would have an impact on the political processes involved, i.e., corporate control over workers, authoritarian labor relations and professionalism, and resources of the state institutions.

Collective Bargaining↗
PubMed1987

Industrial democracy. The Victorian health sector experience.

There is growing evidence to suggest that the principles of industrial democracy have been adopted by two of the major players in the delivery of health care, namely, the unions and the Labor Government. The opportunity now exists for health service administrators to manage participatively the introduction of this relatively new concept. For this participation to be effective there must be an improvement in the current level of understanding by health service managers of employee participation techniques and initiatives.

Australia↗
PubMed2000

Electoral democracy, revolutionary politics and political violence: the emergence of Fascism in Italy, 1920-21.

This study examines the determination of the Italian Fascists' extra-parliamentary, para-military, violent strategy. What were the effects of the socialists' political strategy, relying on electoral democracy, on the creation and strategy of the Fascist Action Squads? A comparison among Italy's 69 provinces, based on quantitative and qualitative historical evidence reveals a distinct pattern in the Fascists' violence. They attacked mainly provinces where the Socialists enjoyed the greatest electoral support. This pattern was a product of two historical processes: (a) the threat of the Socialist party to the landlords' economic and political hegemony, and (b) the landlords' tradition of militant anti-worker organization which culminated in their alliance with the Fascists. The Fascists' struggle for, and takeover of, political power was not an immanent historical necessity. It was first and foremost an anti-socialist reaction. It was shaped both 'from below', by the political power and radicalism of the PSI and the para-military capacity of the Fascist Squads; and 'from above', by the active support the Fascists received from the landlords and the state. Supported by organized landlords and blessed with the authorities' benevolence, the Squads were able to destroy - physically and politically - the legitimately constituted provincial governments of the Socialists. The alliance with the landlords determined the Squads' almost exclusive attacks on Socialist provincial strongholds that constituted the greatest threat to the landlords' interests, while provinces dominated by the ruling Liberal party were excluded from the Squads' path of 'punitive expeditions'.

Democracy↗
PubMedDate not supplied

Politics of the aged: orientations and behavior in major liberal democracies.

Do the political outlook and electoral behavior of the elderly differ notably from that of younger adults in leading capitalist democracies? A cross-national examination of poll data suggests that on the whole they do not. Among the aged certain cross-national differences in rates of political participation beyond voting may be related to differences in national socio-political structures as well as differences in individual attributes.

Adolescent↗
PubMed1995

Health system reforms in industrialized democracies: an emerging paradigm.

Despite the wide variety of health care systems in industrialized democracies, a universal paradigm for financing, organization, and macromanagement has been emerging through reforms of the past decade. The policies within this paradigm attempt to promote equity, social efficiency, and consumer satisfaction by combining the advantages of public finance principles--universal access and control of spending--with the advantages of competitive market principles--consumer satisfaction and internal efficiency. This paradigm is characterized by three systemic functions: (1) financing of care, based on public finance principles, not necessarily carried out by government; (2) organization and management of publicly funded care consumption by either competing nongovernmental entities or noncompeting public administrations; and (3) provision of care based on competitive market principles. The institutional arrangement of these functions lends itself to the creation of two internal markets for consumer choice and, of the three, the second function is a key component of the emerging paradigm.

Australia↗
PubMed1997

Immigration as a source of political discontent and frustration in Western democracies.

"This article describes the migration context of three sets of Western democracies and then explores plausible linkages between the scale, timing, and characteristics of migration, and the substance and process of migration policies, on the one hand, and support for government, on the other. Trying to move beyond plausibility, I discuss indirect indicators of the impact of immigration on Western publics: attitudes toward immigration policy and immigrants, support for extremist parties, and acts of violence and disorder linked to anti-immigrant or racist motives."

Attitude↗
PubMed2002

Nuclear democracy. Political engagement, pedagogical reform, and particle physics in postwar America.

The influential Berkeley theoretical physicist Geoffrey Chew renounced the reigning approach to the study of subatomic particles in the early 1960s. The standard approach relied on a rigid division between elementary and composite particles. Partly on the basis of his new interpretation of Feynman diagrams, Chew called instead for a "nuclear democracy" that would erase this division, treating all nuclear particles on an equal footing. In developing his rival approach, which came to dominate studies of the strong nuclear force throughout the 1960s, Chew drew on intellectual resources culled from his own political activities and his attempts to reform how graduate students in physics would be trained.

History↗