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PubMed2006

Fitness extraction and the conceptual foundations of political biology.

In well known formulations, political science, classical and neoclassical economics, and political economy have recognized as foundational a human impulse toward self-preservation. To employ this concept, modern social-sciences theorists have made simplifying assumptions about human nature and have then built elaborately upon their more incisive simplifications. Advances in biology, including advances in evolutionary theory, notably inclusive-fitness theory, have for decades now encouraged the reconsideration of such assumptions and, more ambitiously, the reconciliation of the social and life sciences. I ask if this reconciliation is feasible and test a path to the unification of politics and biology, called here "political biology." Two new notions, "fitness extraction" and "fitness exchange," are defined, then differentiated from each other, and lastly contrasted to cooperative gaming, the putative essential element of economics.

Journal Article↗
PubMed2000

[Changes in health politics].

In the last 25 years we observed in health politics an impressive transition, always more important became money. The big majority of physicians is not interested in politics, neither in health politics, they permit, that there is made politics with them. Often the "health war" (Clausewitz) is more important for them than "the art of the possible" (Bismark). There are many groups and many competences, but until now everybody forgot to allot the competences clearly to the different groups. Decisions are made with few competence, with "an empty brain". Additional services are demanded for the same money, as Mrs. Dreifuss of the Swiss Federal Council does. She wishes the neutrality of cost, but more services.

Cost-Benefit Analysis↗
PubMed2004

[Misdiagnosed PTSD and zeldox pharmacotherapy in case of a political prisoner].

Treatment of survivors of political terror is an emerging and difficult field. Reports on posttraumatic stress disorder (PTSD) in political prisoners within the former Eastern Block countries is low and mostly restricted to German sources. During the totalitarian period administrative and clinical decisions often had to take into account political realities not found in other treatment environments. That practice might have lead to biased professional training, lack of experience extending into the post-communist era and leading to current underpresentation of PTSD. The authors present a case report of a Hungarian political prisoner with long history of PTSD who had a "carry over" diagnosis of paranoid schizophrenia even 15 years after the collapse of the communist regime. After decades of continuous administration of antipsychotic and antidepressive medications, either alone or in combination, Zeldox monotherapy has proven to be the most effective treatment for this patient.

Antipsychotic Agents↗
PubMed1991

[Medical politics. Graffiti].

If doctors want to play a role in future health promotion, they have to leave their citadel, and come closer to life and society. Modern preventive medicine cannot be dissociated from basic political, cultural and religious values and processes. Genetic counseling and engineering, influencing lifestyle, community intervention and changing the health culture among patients and doctors all require ethical and political competence rather than traditional medical skills. The author advocates the development of a new discipline, medical politics, with two major commitments: -To define basic health rights -To study the public health consequences of political systems and decisions. In a polemic and provocative style the article enlightens the potentials and dangers associated with an expanded concept of preventive medicine.

Environmental Health↗
PubMed2005

Kinship-based politics and the optimal size of kin groups.

Kin form important political groups, which change in size and relative inequality with demographic shifts. Increases in the rate of population growth increase the size of kin groups but decrease their inequality and vice versa. The optimal size of kin groups may be evaluated from the marginal political product (MPP) of their members. Culture and institutions affect levels and shapes of MPP. Different optimal group sizes, from different perspectives, can be suggested for any MPP schedule. The relative dominance of competing groups is determined by their MPP schedules. Groups driven to extremes of sustainability may react in Malthusian fashion, including fission and fusion, or in Boserupian fashion, altering social technology to accommodate changes in size. The spectrum of alternatives for actors and groups, shaped by existing institutions and natural and cultural selection, is very broad. Nevertheless, selection may result in survival of particular kinds of political structures.

Culture↗
PubMed1992

Politics as an environmental factor in population development: reviewing the South African situation.

The political factors that affect the development of a successful population policy in South Africa are examined. "It is concluded that despite the important role of socioeconomic development, the success of the population development programme ultimately depends upon (a) the actual distribution of political power to all communities; (b) the degree of legitimacy enjoyed by the government among the broader population; and (c) a general political consensus regarding the urgency for curbing the population growth rate."

Africa↗
PubMed2007

Introducing Health Impact Assessment: an analysis of political and administrative intersectoral working methods.

BACKGROUND: Intersectoral Action for Health (IAH) and its Health Impact Assessment (HIA) tool are built on collaboration between actors and sectors, requiring multidimensional and horizontal way of working. The study aims to analyse the enablers and barriers when such a new way of working and tool have been initiated to replace a traditional, vertical operation at the local level in Slovakia-a country in transition-in 2004. METHODS: Up to date, there are few studies that have analysed intersectoral initiatives in relation to politics. In this study the conceptual framework of Kingdon has been used by which the actual problems, the governmental actions (or non-actions) (politics) and the understanding, implementation and evaluation of the initiative (policy) could be analysed. All actors involved, civil servants, politicians, representatives of the local public health institute and researchers, were interviewed and made to answer a questionnaire. RESULTS: The results showed that there were a number of factors behind the initiation of HIA, which either delayed or accelerated the process. The problems identified were e.g. the prevailing traditional health care focus and the deteriorating health status of the population. There was a lack of multi-intersectoral knowledge, co-operation and function between sectors and actors. Enablers on the other hand were the membership of international organizations which called for new solutions, and the strong political commitment and belief that intersectorality would have a positive effect on health. CONCLUSION: The actors on the local level would have the capacity to work intersectorally to bring about policy change if HIA was to be more supported/institutionalized.

Community Health Planning↗
PubMed1991

Production and the welfare state: the political context of reforms.

This article is an analysis of the political context of reforms in the production process and in the welfare state. The theories of legitimation and Fordism are criticized for considering the capitalist class the main force behind the reforms. The working class and the process of class struggle are primarily responsible for changes in production and for the establishment of the welfare state. The author then shows that the changes in production and in the state that occurred after World War II were a response to political events triggered by labor's rebellions and capital's need to respond to those rebellions. Post-Fordism and the political practice that derives from it are criticized for their hasty dismissal of class and class practices by the dominated forces in society. The article ends by offering an alternative strategy for change.

Europe↗
PubMed1985

Resistance to the political representation of alien populations: the European paradox.

This article addresses the issue of the resistance of European nations to granting unnaturalized citizens the right to vote in local, regional, and national elections. It argues that this political inflexibility contrasts with the economic flexibility these nations demonstrated when they made a call for labor to overseas populations, former colonies, and other countries, and which they exhibit now as they work to modernize production systems in their industries. Because of this lack of political representation, local authorities have proven disinterested in migrants' concerns and migrants have become subjects of the labor market, rather than of the law. Overall "political underdevelopment" will only intensify the turbulence projected for Europe's economy.

Demography↗
PubMed2006

Public roles of US physicians: community participation, political involvement, and collective advocacy.

CONTEXT: Whether physicians have a professional responsibility to address health-related issues beyond providing care to individual patients has been vigorously debated. Yet little is known about practicing physicians' attitudes about or the extent to which they participate in public roles, which we defined as community participation, political involvement, and collective advocacy. OBJECTIVES: To determine the importance physicians assign to public roles, their participation in related activities, and sociodemographic and practice factors related to physicians' rated levels of importance and activity. DESIGN, SETTING, AND PARTICIPANTS: Mail survey conducted between November 2003 and June 2004 of 1662 US physicians engaged in direct patient care selected from primary care specialties (family practice, internal medicine, pediatrics) and 3 non-primary care specialties (anesthesiology, general surgery, cardiology). MAIN OUTCOME MEASURES: Rated importance of community participation, political involvement, collective advocacy, and relevant self-reported activities encompassing the previous 3 years; rated importance of physician action on different issues. RESULTS: Community participation, political involvement, and collective advocacy were rated as important by more than 90% of respondents, and a majority rated community participation and collective advocacy as very important. Nutrition, immunization, substance abuse, and road safety issues were rated as very important by more physicians than were access-to-care issues, unemployment, or illiteracy. Two thirds of respondents had participated in at least 1 of the 3 types of activities in the previous 3 years. Factors independently related to high overall rating of importance (civic-mindedness) included age, female sex, underrepresented race/ethnicity, and graduation from a non-US or non-Canadian medical school. Civic mindedness, medical specialty, practice type, underrepresented race/ethnicity, preceptors of physicians in training, rural practice, and graduation from a non-US or non-Canadian medical school were independently related to civic activity. CONCLUSIONS: Public roles are definable entities that have widespread support among physicians. Civic-mindedness is associated primarily with sociodemographic factors, but civic action is associated with specialty and practice-based factors.

Attitude of Health Personnel↗
PubMed1985

Politics and abortion.

The legalization of abortion in the United States by the Supreme Court in 1973 bypassed the political process in the majority of the states. Since then, however, political controversy and agitation in relation to abortion has become nationwide. From largely Catholic-based opposition, it has grown to encompass religious fundamentalists and to be a major part of the New Right's agenda. Abortion is now, pro and con, part of the platform of both political parties. The sweeping nature of the Supreme Court's decisions leaves the opposition with very little room to restrict abortion, short of overturning the decisions through a constitutional amendment. Such an amendment requires a two-thirds majority of Congress and passage is unlikely. However, funding bans on scores of federal programmes have succeeded in restricting access to abortion for the poor, the young and minorities. These restrictions are part of a long-term strategy to educate the public as to the evils of abortion with the aim of making it illegal again, either through the adoption of a constitutional amendment or by obtaining a reversal by a hoped-for change in membership of the Supreme Court.

Abortion, Induced↗
PubMed1992

Determinants of a merger in a publicly-funded health system: a political-economy perspective.

This article reports the results of a case study, spanning a period of 10 years, of the merger of two hospitals in a publicly-funded health system. A political economy model was used to analyse the determinants of the merger. Results show that external political economy factors, mainly pressure from the state to rationalize health services and the organization's needs to acquire critical resources, significantly contributed to the merger decision. At the internal political economy level, groups and individual strategies also played a determinant role. Our study suggests that merger in the public sector may not necessarily result from efficiency motives.

Health Facility Merger↗
PubMed1991

Emotional distress and its socio-political correlates in Salvadoran refugees: analysis of a clinical sample.

The emotional distress responses of refugees cannot be adequately understood using the traditional notions of stress and adaptation. In these populations it is necessary to consider the relations between emotional distress and socio-political context, particularly the processes of terror and intimidation and the conditions of migratory illegality and social marginality. This study analyses the patterns of emotional distress in a clinical sample of 71 Salvadoran refugees in an urban center of the United States. Case histories are presented and patterns of trauma, distress and associated life problems analyzed. It is argued that distress patterns reflect the particular socio-political conditions of women and men and represent the embodiment of the conflicts that refugees face. The concept of illness is used to link distress patterns and socio-political context and to avoid the reductionism of psychiatric categories.

Adult↗
PubMed2000

Political change and course of schizophrenia in East Germany, 1984-1994.

BACKGROUND: We tested the hypothesis that the political change occurring in East Germany after the fall of the Berlin Wall in November 1989 affected patients with long-term schizophrenia, resulting in more and longer hospitalisations. METHODS: In two samples in East Germany (120 patients in East Berlin, 70 patients in Chemnitz) and in a control group from West Berlin (40 patients), hospitalisations for each month between November 1984 and October 1994 were assessed. Each sample included all schizophrenia patients who were in continuous treatment in the given community mental health centre throughout the full observation period. RESULTS: Hospitalisation indices were not higher after November 1989 than before in any of the groups. CONCLUSIONS: There is no evidence that political change in East Germany negatively affected the course of longterm schizophrenia as assessed by hospitalisations. If consistent medical care is provided, characteristics of the political system may have less impact on the course of schizophrenia than is sometimes assumed.

Adult↗
PubMed2005

Society's symbolic order and political trials: toward sacrificing the self for the "Big Other".

The need to establish a borderline between legitimate and illegitimate political trial is one of the central societal discourses. In this paper the author claims that the issues are complex and that a political trial can remain legitimate as long as it is not dealing with a confrontation with the symbolic order on which the society (and the court itself) is founded and as long as the subject (or action) it is dealing with does not threaten the symbolic order's (or the "Big Other") existence. When the symbolic order's existence is in danger, the court is bound to participate in an act of "sacrifice" that is intended to protect the "order." The author uses Jacques Lacan's psychoanalytic theory of the "Big Other" (and its development to ideological-political terms) in examining three categories of sacrifice. Through these categories the author claims that in extreme cases of confrontation with the existence of the symbolic order, the court cannot remain objective and it would be difficult to justify the trial as legitimate (especially in historical perspective).

Criminal Law↗
PubMed1982

Managing change strategically: the technical, political, and cultural keys.

The turbulent economic, political, and cultural forces of the 1980s have made the management of strategic change increasingly a way of life for organizations. To manage such change, managers will have to confront basic questions about the organization's technical, political, and cultural foundations. The technical questions include: What business(es) should we be in? How should we be organized to accomplish our strategy? What kinds of people do we need, and how will they be acquired, developed, and rewarded? The political questions include: Who gets to influence the mission and strategy of the organization? Who gets promoted to what key positions? The cultural questions: What values and beliefs are necessary to support the organization's strategy? What subcultures are desirable, and should there be an overarching corporate culture? The author suggests that the answers for an individual organization should cluster to form three strands of a strategic rope--that is, they must be interwoven and mutually supportive for the organization to be effective. He sees human resources management as the focal point of much of strategic change likely to occur in organizations during the 1980s.

Culture↗
PubMed1994

A cross-national analysis of midwifery politics: six lessons for midwives.

Research based on interviews and analysis of documentary sources on the politics of midwifery in Canada, Denmark, the Netherlands, the UK and the US, suggests six political lessons for midwives and the organisations that represent them. The lessons are: general health reforms represent both an opportunity and a threat to midwives' status, and midwives must learn to communicate in ways policy makers understand; research matters; coalition building is essential; the media cares (a little); it is much easier to defend the status quo than create new policy; it is essential to clarify who is to be considered a midwife. A constant grass roots awareness of and involvement in a country's political and policy making process is seen as a necessity if midwives are to prosper as a profession.

Cross-Cultural Comparison↗
PubMed1984

Medical politics: decline in the hegemony of the Australian Medical Association?

The last 15 years have seen the emergence of medical associations challenging the long-standing hegemony of the Australian Medical Association (A.M.A.) in medical politics. The article focuses on the two major groups. The General Practitioners' Society in Australia and the Doctors Reform Society. Each represents the right and the left of an ideological spectrum within medical politics. Each has institutionalised longer term division within the profession which were contained within the A.M.A. so long as the basic principles and structure of Australia's voluntaristic health insurance schemes remained intact. Taken together, they represent a wider critique of the entrenched status and political power of the A.M.A. The article examines briefly the ideology, strategy and impact of each group. It concludes that their major significance lies, not in their effectiveness as pressure groups, but as they have affected the public image of the A.M.A. and of the profession as a whole. The future of each depends on secular changes affecting medicine and the profession, on the oversupply of doctors on economic stringencies, and importantly, on the reaction of the A.M.A. to critiques of its representative function.

Australia↗