Bringing political ecology into critical medical anthropology: a challenge to biocultural approaches

This essay presents an effort to incorporate the "environment" into critical medical anthropology. Rather than relying upon the multifactorial approach characteristic of medical ecology or biocultural approaches in medical anthropology, it urges critical medical anthropologists to turn to the burgeoning literature on eco-Marxism, eco-socialism, or political ecology in their efforts to develop a political ecology of health. Given that political ecologists generally advocate democratic eco-socialism as a meaningful alternative to the capitalist world system, this essay also presents a critical examination of the environmental record of post-revolutionary societies.     

Predicting One's Own Forgetting: The Role of Experience-Based and Theory-Based Processes.

The authors examined the hypothesis that judgments of learning (JOL), if governed by processing fluency during encoding, should be insensitive to the anticipated retention interval. Indeed, neither item-by-item nor aggregate JOLs exhibited "forgetting" unless participants were asked to estimate recall rates for several different retention intervals, in which case their estimates mimicked closely actual recall rates. These results and others reported suggest that participants can access their knowledge about forgetting but only when theory-based predictions are made, and then only when the notion of forgetting is accentuated either by manipulating retention interval within individuals or by framing recall predictions in terms of forgetting rather than remembering. The authors interpret their findings in terms of the distinction between experience-based and theory-based JOLs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The imagery debate: Analogue media versus tacit knowledge.

Argues that the main point of disagreement in the debate over the nature of mental imagery concerns the following: (a) whether certain aspects of the way in which images are transformed should be attributed to intrinsic knowledge-independent properties of the medium in which images are instantiated or the mechanisms by which they are processed; or (b) whether images are typically transformed in certain ways because Ss take their task to be the simulation of the act of witnessing certain real events taking place and therefore use their tacit knowledge of the imaged situation to cause the transformation to proceed as they believe it would have proceeded in reality. The tacit knowledge account is seen as more plausible because empirical results demonstrate that both "mental scanning" and "mental rotation" transformations can be critically influenced by varying the instructions given to Ss and the precise form of the task used and, that the form of the influence is explainable in terms of the semantic content of Ss' beliefs and goals. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Whose fault is it? People's own conceptions of the reasons for health inequalities

How do people themselves think about inequalities in health? The topic has rarely been investigated, and oblique evidence has to be drawn from research on general lay ideas about health and the causes of illness. Data from a large British survey are combined with a review of the extensive body of, more usually, qualitative research on attitudes to health in Western industrialised societies. One tentative conclusion is that social inequality in health is not a topic which is very prominent in lay presentations, and paradoxically this is especially true among those who are most likely to be exposed to disadvantaging environments. Possible explanations are offered in terms of the effects of widespread "health promotion" activities, and the way in which lay theorising incorporates relationships between the group and the individual. The methods used in asking people to talk about health are also relevant: accounts of health and illness are accounts of social identity, and it is unreasonable to expect people to devalue that identity by labelling their own "inequality".     

Why is psychoanalysis so controversial? Notes from left field!

Psychoanalysis is defined as a method and as an ontology of mental life. Its controversies are discussed both in terms of those within the discipline and in terms of the attacks on its scientificity by the proponents of "normal science" (analytico-referential or logical-empiricist). It is argued that the discoveries achieved by the free-associative method call into question the metaphysical assumptions on which all "normal science" is constructed. By showing that human consciousness is composed contradictorily of two dimensionalities of meaningfulness (semiosis and desire), psychoanalytic method challenges the axioms of a centered or unified rational subject that can aspire to formulate univocal "truths" about the self and its world. Our discipline thereby insists on a new notion of truth and of the knowing subject's relation to its own being. It is suggested that psychoanalysis is thus a "revolutionary science," in ways that have yet to be fully comprehended, and its method implies a critique of the underlying precepts of all mainstream psychology. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

How do underlying "self" and "other" dimensions define adult attachment styles?

Assumptions about dimensions underlying the four prototype model of adult attachment were explored in two studies. In the first (N = 225), associations between attachment prototype ratings and standardized measures of self and others in relationships were examined. In a second study (N = 246), measures of anxiety and avoidance were added to the analyses. Findings from correlational and hierarchical regression analyses provided support for the notion, contrary to assumptions of the model, that qualitatively different self and other dimensions underlie different attachment styles. Results are discussed in terms of the lack of equivalency in measures of "self" and "other" proposed to underly each of the four attachment style ratings, the need to view attachment styles as complementary rather than mutually exclusive, and the need to continue exploration of the dimensions informing attachment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physicians' view of practice guidelines. A survey of Italian physicians

After more than 10 years of development, two different views of practice guidelines are emerging: either as an educational tool for the medical profession, or as a forum where health care issues can be debated by physicians and non-medical groups. Physicians use practice guidelines in the former model to set their own standards of good quality care, while the latter approach needs contributions from other components in order to decide what should be provided by our health care systems. In a survey of Italian physicians' opinions and attitudes toward practice guidelines, responders supported the "narrowest" model. More than 80% stated that improvement of quality of care and reduction of variation in clinical and practice styles should be the aim of practice guidelines, without representatives from outside the medical profession being involved (61%, 79% and 86% disagreed with a possible involvement, respectively, of patients, health care administrators and representatives of the public at large). Overall, 38% of physicians had a positive attitude toward guidelines viewed as a quality assurance tool for the medical profession. Overall, physicians seem to ignore that the need to rationalize health care calls for input from other professions and members of society. Indeed, most of the issues facing medicine today are mainly a matter of how much value our societies attach to the benefit expected from the available health services. The answers as to what should be done in health care probably cannot be left to the medical profession alone.     

Protecting women and children from physical, sexual, and psychological abuse

Domestic violence is a serious public health problem. The "epidemic" is becoming too obvious to hide, too widespread to deny, and too much of a health hazard to ignore. The victims are children, women, the elderly, and the society as a whole. Family members, government, educational and penal agencies, civic and medical societies, physicians, and citizens at large are all involved in domestic violence prevention. By having a high index of suspicion, physicians are in an ideal position to prevent, assess, identify, and treat victims of domestic violence and its associated problems.     

Malpractice: Professional liability and the law.

Contends that psychologists typically possess only the most rudimentary understanding of the medical–legal concept surrounding today's professional malpractice suits. This article explores the elements making up the underlying concept of negligence and the related notion that it should ultimately be the profession itself, and not the jury, that determines the standard of care with which the accused provider must be compared. Although the proof of provider negligence, or "fault," is the present basis of malpractice, the inherent inappropriateness of such a conceptual model for most medical and especially therapeutic "injuries" is stressed. A recently enacted Hawaii statute establishing medical–legal "claim conciliation panels" is prefered as a logical step in the eventual evolution of a pure "no-fault" approach to the rising incidence of health care suits. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evolution of the thought of "Yojo" and its function as a theoretical bases for development of health culture

The purpose of this monograph is to clarify the role of "Yojo" on public health in Japan. Yojo is a traditional concept which has been used for the nourishment of life in Eastern cultures. These thoughts on Yojo were published under the title of Yojoron in ancient China. Yojoron was imported into Japan somewhere from the 7th to 10th centuries. In ancient and medievel Japan, there were few writings about Yojoron. However during the Edo period, Yojoron suddenly flourished. Dominant in Yojoron was diet. Issues such as exercise, mental control, and sexual restraint were also considered in the Bunka, Bunsei, and Tenpo periods (the first half of 19th century). Yojoron included not only matters of physical and mental health but various other matters regarding the general quality of life such as morality, domestic economy, culture and education. However other health-related issues such as longevity and absence of diseases, showed a simultaneous decrease in the importance. Also principles of Yojoron such as restraint and austerity in behaviour were liberalized. These trends indicated the basic shift in Yojoron from personal health care to self-culture for the entire quality of life. Writings on Yojoron were still published after the Meiji restoration (1868). The principle of Yojoron in the Meiji period was based on both social Darwinism and social revolution theories. The primary concerns of Yojoron were consolidated into achieving health and longevity by personal effort. Therefore Yojoron can be seen as the theory of lifestyle and quality of life in traditional societies in Japan. The public saw in Yojoron a design for living through improved health. This meant the Yojoron was a very refined art of living, and therefore, implies that health care should be integrated with entire self-development. The principle of Yojo offers the ideal foundation of 'health culture' in modern societies.     

Shaping space: the possible and the attainable in RNA genotype-phenotype mapping

Understanding which phenotypes are accessible from which genotypes is fundamental for understanding the evolutionary process. This notion of accessibility can be used to define a relation of nearness among phenotypes, independently of their similarity. Because of neutrality, phenotypes denote equivalence classes of genotypes. The definition of neighborhood relations among phenotypes relies, therefore, on the statistics of neighborhood relations among equivalence classes of genotypes in genotype space. The folding of RNA sequence (genotypes) into secondary structures (phenotypes) is an ideal case to implement these concepts. We study the extent to which the folding of RNA sequence induces a "statistical topology" on the set of minimum free energy secondary structures. The resulting nearness relation suggests a notion of "continuous" structure transformation. We can, then rationalize major transitions in evolutionary trajectories at the level of RNA structures by identifying those transformations which are irreducibly discontinuous. This is shown by means of computer simulations. The statistical topology organizing the set of RNA shapes explains why neutral drift in sequence space plays a key role in evolutionary optimization.     

Values as predictors of judgments and behaviors: The role of abstract and concrete mindsets.

This research makes strides toward reconciling mixed findings in the value-behavior relation by positing that values are abstract representations of ideal end states that are more likely to influence behavior when individuals think abstractly (vs. concretely) and focus on high- (vs. low-) level motivations for interpreting their actions. In 6 experiments, the authors measured the importance of values (or made them salient via a priming procedure) and simultaneously manipulated accessible mindsets (abstract vs. concrete), and assessed their effect on judgments and behaviors. An abstract (and not a concrete) mindset led participants to engage in judgments or behaviors that were consistent with a broad range of values, including power, benevolence, universalism, self-direction, individualism, and collectivism. These results support the notion that values are more likely to be expressed through value-congruent judgments and behaviors when individuals think abstractly about their actions, and not when they think concretely. Two of the experiments examined the process underlying these effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Participative development calls for a participative concept of communication

The most common approach to health communication, characterized by a top-down, one way flow of information through which individuals and communities are provided with solutions to their problems, is increasingly in question. The belief that the main goal of health communication programmes is to disseminate carefully worded messages to community target groups in order to trigger individual behaviour change is increasingly questioned in terms of both effectiveness and appropriateness. An alternative belief is that the aim of these programmes should be to involve both community members and health workers in critical analysis of health problems and potential solutions in order to develop strategies for action. This article describes two contrasting models of communication, the "information-dissemination for individual change model" and the "participatory, problem solving for action model". The two models are discussed in terms of the communication process, levels of programme intervention, communication activities and communication materials and an argument is given for the participatory model with examples of successful programmes that have adopted this approach.     

Conformity--Good and Bad.

In reading Marie Jahoda's "Psychological Issues in Civil Liberties," (American Psychologist, 11, 1956, pp. 234-240) I was struck with the ambiguous use of the term "conformity" and the alarm which borders on the hysterical. Lest the unwary reader swallow this seeming hysteria uncritically, some clarification of the semantical differences in the term is in order. There is no argument here with the praiseworthy experimental design and methodology which Jahoda presents--it is with her ambiguous concept of "conformity." "Conformity" as used by Jahoda connotes a collective adherence by an irrational society to drab and erroneous beliefs or doctrines. Thus, the terms "arid conformity" and "stultifying conformity." There is the other concept of conformity which describes the value preferences of highly civilized societies. There is the other concept of conformity which describes the value preferences of highly civilized societies. The first connotation would apply to Hitler's Germany--the authoritarian and ethnocentric society that savagely eliminated those who disagreed. The second or favorable connotation applies to those values, laws, and institutions which have been formulated and refined with blood and tears down through the centuries and are now "conformed" to and "adhered" to by Englishmen and Americans with an intuitive grasp of their worth. In this sense no society is possible without conformity. It is our thesis that conformity (in the second sense) is necessary; and that sanctions of some sort are indispensable in order that any conformity be achieved in an orderly society. The sanctions or coercions take different forms: education, social pressures, and laws. The alarm with which liberals view these sanctions becomes clear when the concept of relativity is invoked. They formulate an inflexible doctrine of "freedom" which prohibits sanctions of any kind. Thus, through their tinted glasses of "license," every move is labeled "thought control," "book burning," or stultifying "conformity." Liberals should examine themselves for "self-consistency." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual approaches to the diagnosis of stress-induced functional disorders in humans under conditions of industrial activity

In accordance with the fundamental concept of the systems symmetrical approach, a model of the body's "ideal functional status" and a polyparametric method for diagnosing the human functional status (the method has been patented in Russia) were developed, on the basis of the unified set of amplitude and time parameters of a complex of physiological parameters (ECG, etc.). The systems symmetrical approach is basically new in defining the ratio of harmonic parameters acting as new diagnostic evidence for the health status. The unchanging ratio of parameters of autovariation processes in the cardiac, vascular, and respiratory systems, their changes in the development of the adaptative syndrome and the value were examined in healthy individuals at rest and during exercise an intensive productive activity (point brazing at a plant of electron devices), and in the trainees. It was demonstrated that the mechanism of development of adaptative processes was associated with the synchronization of autovariations in the cardiorespiratory and vascular systems and the involution of adaptative processes, their break, depletion, i.e. stress, were determined by the imbalance of relationships and the desynchronization of autovariations in these systems. To define a set of cardiorespiratory and hemodynamic parameters is necessary, but insufficient to evaluate (diagnose) the health status and health-disease intermediate diseases (stress and adaptative overtension). The ratio harmonicity of these parameters, i.e. well-balanced relations between the subsystems is the main characteristic. The assessment of the human health status in terms of the reference-the model of the ideal status as the ideal health status without using the complex and indefinite concept of the normal and moderate health status-is conceptual for polyparametric status estimation.     

Differential regulation and ATP requirement for caspase-8 and caspase-3 activation during CD95- and anticancer drug-induced apoptosis

Although widely used, terms associated with consumption of alcohol--such as "light," "moderate," and "heavy"--are unstandardized. Physicians conveying health messages using these terms therefore may impart confusing information to their patients or to other physicians. As an initial attempt to assess if informal standardization exists for these terms, the present study surveyed physicians for their definitions of such terms. Physicians operationally defined "light" drinking as 1.2 drinks/day, "moderate" drinking as 2.2 drinks/day, and "heavy" drinking as 3.5 drinks/day. Abusive drinking was defined as 5.4 drinks/day. There was considerable agreement for these operational definitions, indicating there is indeed an informal consensus among physicians as to what they mean by these terms. Gender and age did not influence these definitions, but self-reported drinking on the part of physicians was a factor. We also asked physicians for their opinions regarding the effects of "light," "moderate," and "heavy" drinking on health in general and specifically on health-related implications for pregnant women, and whether they felt their patients shared these beliefs.     

Leadership in nursing in Brazil: approaching its demystification

This study aims at understanding the view about the nursing leadership question, through critical analysis of the literature produced predominantly in Brazil on this theme, from 1930 to 1995, contributing to its "dismythification". From the assumption that nursing is a social practice, and therefore articulated with other health practices, we conducted the investigation under a historical-social approach. Empirical data were obtained from the discourses about the issue or related themes, contained in 14 periodicals, from which 12 were of nursing. Besides them, we used proceedings from nursing events, as well as research and researcher catalogs and 3 theses. We analysed data according to time delimitation, distributed in four historical periods, intending to maintain the similarity of the peculiar discourses of each period, according to the context in these moments. The study demonstrated that the nursing leadership question has been treated, in the profession, in an idealized, mythical and crystalized way, contributing, thus, to the maintenance of the status quo and nursing professional's alienation.     

Alcohol and the U.S.-Canada border: trade disputes and border traffic problems

The public health interest in trade and in cross-border traffic of alcoholic beverages is considered in general terms. Within this framework, three specific issues in U.S.-Canada trade and borders are discussed: cross-border drinking and driving in both directions, particularly by youth; smuggling from the U.S. to Canada; and the "beer wars" and other U.S.-Canada trade disputes involving alcoholic beverages. While problems can be alleviated on each of these fronts, it is concluded that an important step internationally would be to establish that, because of the problems they entail, alcoholic beverages should be exempt from trade agreements, or else provision should be made for the public health interest to be represented in negotiations and dispute resolution involving alcoholic beverage controls.     

Adverse effects of cannabis

Cannabis is the most widely used illicit drug in many developed societies. Its health and psychological effects are not well understood and remain the subject of much debate, with opinions on its risks polarised along the lines of proponents' views on what its legal status should be. An unfortunate consequence of this polarisation of opinion has been the absence of any consensus on what health information the medical profession should give to patients who are users or potential users of cannabis. There is conflicting evidence about many of the effects of cannabis use, so we summarise the evidence on the most probable adverse health and psychological consequences of acute and chronic use. This uncertainty, however, should not prevent medical practitioners from advising patients about the most likely ill-effects of their cannabis use. Here we make some suggestions about the advice doctors can give to patients who use, or are contemplating the use, of this drug.