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Seizures induced by frustration and despair due to unresolved moral and political issues: a rare case of reflex epilepsy.

We present a case of reflex-induced simple partial seizures, triggered by feelings of frustration, anger and despair. Such emotions were provoked by pondering over complex national and international, political and moral issues. The present case may suggest that activation of right temporal networks may mediate negative and adverse emotions induced by preoccupation with agitating, controversial issues.

Aged↗

Politics in the birthing room.

Women have always braved their way through childbirth one way or another. The hands surrounding them as they make their journey have offered many things. For some it has been herbs or a totem to hold. For others, it has been a tether to a beeping machine or a drug to transform the experience. No one has yet found the method(s) that addresses every pregnant woman's fear or pain during labor and birth. And no one can truly guarantee that all will be okay. The contemporary medical profession offers to shoulder the burden for women by "taking care of it for them," The managed care industry assures the public that they will provide pregnant women with the highest quality of care and the greatest decision-making power. Elected officials promise that they will save women and newborns from unscrupulous legal practices and from the abuses of managed care. But these goals, for better or worse, have yet to be fully realized. No matter the circumstances, women will continue to have babies. Their labors will be short or long, will occur surrounded by flowered décor or in sterile wards, and will be attended by physicians who are overburdened by the demands of maintaining a practice or by a midwife who must battle with institutional protocols to care for her clients. The battle for the political victories in women's health care will undoubtedly continue for some time to come. The strength and resolve of women and their families will determine the outcome and give voice to the consumer and the midwife in the board-room, in the hearing room, and in the birthing room.

Delivery, Obstetric↗

The Nation's Health: when epidemiology meets ethics and politics.

The main conclusions of The Nation's Health: a Strategy for the 1990s-a 10 year review of public health in the UK-are presented. The interrelation between the epidemiological, ethical and political dimensions encountered in the preparation and publication of the report are discussed. An initial appraisal of the impact of the report on public health awareness and policy is presented.

Epidemiology↗

Economic and political implications of immunology and aging on tomorrow's society.

The historic development of immunology is associated with Eli Metchnikoff who introduced the term 'gerontology' in 1906. Metchnikoff also understood the impact of population aging on society as revealed in two remarkable books. The immune system is relevant to aging in so many ways immunesenescence, the potential role of immunological changes in the dementias, the interrelationship of immune resistance and bereavement, retirement and other life changes and transplantation biology and pathology. These are only a few examples of the interrelationships of immunology and aging. The economic and political implications of immunology and aging are rarely discussed. If we are not able to cure the disorders of longevity, we need to delay their onset and progression. Such an effort is enhanced by modern biology including recombinant DNA and Hybridoma technology. Many in society fear the growing numbers of older persons-can we afford old age? Will population aging lead to stagnation of society and will there be intergenerational conflicts? These gloomy notions are not entirely offset by enthusiasm for an extended high quality longevity. This presentation will discuss these various issues and offer positive solutions.

Aging↗

The pharmaceutical industry as a political player.

The pharmaceutical industry has produced many drugs that have benefited man. Political frameworks designed to govern the industry must maintain these benefits. However, regulation needs to be sufficiently robust to protect public health from drugs that are unsafe, ineffective, or unnecessary. The extent of industry influence over drug regulation, at the expense of other interested parties, suggests that the current system could be more robust. The many ways in which the pharmaceutical industry can influence governments and regulatory agencies are discussed, and methods by which this influence can be curbed are suggested.

Conflict of Interest↗

Outcome-related health targets--political strategies for better health outcomes: a conceptual and comparative study (part 2).

Based on an analytical model which defines political co-ordinates on two axes (technocratic-participative and top-bottom), the policy documents of national and regional health target programmes in countries of the European Union, Australia, Canada, New Zealand and the USA are analysed in regard to the rationale for and interest in health targets, the involvement of actors in the policy-cycle, the setting of priorities, the distribution of responsibilities and accountability as well as incentives and sanctions used. Most, if not all, target programmes are conceptualised in a 'top-down' manner by the government and its administration with little involvement of the general public or the parliament. Usually, neither necessary alliances at the grass roots level nor appropriate incentives for local or professional actors are discussed in the documents. Many target programmes are, therefore, bound to fail and finding a balance between the right balance between technocratic and participative as well as between top and bottom remains a challenge for setting successful health targets.

Australia↗

Regional disparities in health care supply in eleven European countries: does politics matter?

There are large differences both among and within European countries in the supply of health care facilities and personnel. In 1979 Smith posed the hypothesis that spatial disparities in health care supply will be smaller in countries with socialist (or social-democratic) governments. The aim of this paper is to examine this hypothesis by analysing whether or not regional disparities in health care supply within countries are smaller in countries that have been governed predominantly by socialist governments. We have collected regional data on the number of hospital beds and the number of physicians for 211 regions in 11 European countries for 1970 and 1990. Countries were classified according to the political composition of governments in the post-war era. It is concluded that: (1) the amount of regional variation is greater for hospital beds than for doctors; (2) for both aspects of supply, regional disparities decreased over time; (3) the decrease in regional disparities between 1970 and 1990, both for beds and for doctors in hospitals, was stronger for countries that had more years of socialist government in that period and (4) there is no relation between the number of years of socialist government between 1945 and 1990 and regional variation in health care supply in 1970, nor for government participation between 1970 and 1990 and variation in supply in 1990.

Demography↗

[Smoking prevention as a political issue].

The causes of many health problems such as smoking are beyond individual action. To change them requires the development of interventions dealing with the social factors that cause them, interventions of a political nature. In this paper we review for Spain public policies influencing smoking, with an emphasis on those with greater potential impact (fiscal policies to increase price, and those controlling the promotion and publicity of tobacco products), as well as the role of different government levels in regulation (local, regional central and European). The role of the Central government and of the European Union are crucial today in Spain. Some aspects influencing the adoption of smoking prevention policies (problem definition, private interests, and ideology) are also analyzed, as well as the need for a strategic coalition to promote them.

Global Health↗

Shan women and girls and the sex industry in Southeast Asia; political causes and human rights implications.

The human rights abuses which occur during civil conflicts pose special threats to the health and lives of women. These can include rape, sexual violence, increased vulnerability to trafficking into prostitution, and exposure to HIV infection. The long-standing civil conflict in the Shan States of Burma is investigated as a contributing cause to the trafficking of ethnic Shan women and girls into the Southeast Asian sex industry, and to the subsequent high rates of HIV infection found among these women. The context of chronic human rights abuses in the Shan states is explored, as well as the effects of recent forced population transfers on the part of the Burmese Military Regime. Rights abuses specific to trafficked women may further increase their vulnerability to HIV and other STD. The need for a political resolution to the crisis in Burma is discussed, as are approaches aimed at preventing trafficking, empowering women already in the sex industry, and reducing the risks of HIV and other STD among these women and girls.

Female↗

The health politics of asthma: environmental justice and collective illness experience in the United States.

While public health, medical, government, and community actors agree that there is a serious asthma epidemic, there is significant disagreement over the role of outdoor environmental factors in causing or triggering asthma. The outcome of these disputes is important because it substantially influences the focus of public health prevention and government regulation. Minority communities in the United States have higher morbidity rates than white communities and, as a result, are more readily affected by debates over environmental factors and subsequent public health and government efforts. Therefore, asthma has figured prominently in community activists' agendas concerning health inequalities. We compare and contrast the efforts of two community environmental justice organizations that include asthma as part of their overall community organizing efforts. We explore obstacles and strategies common to both groups as well as key differences in their orientation vis-à-vis science. To do so, we first discuss the discovery, current research, community action, and resultant changes in the understanding of the disease, specifically within poor and minority communities. Then, to offer a context to examine our two examples of asthma activism, we explore the social discovery of asthma and its environmental correlates, along with the political and economic conflicts surrounding asthma research and regulation. Using examples from the two activist groups, we discuss common approaches to address asthma in poor and minority communities such as challenging "transit racism", employing an environmental justice perspective, and using education to empower community members. Finally, we explore how the issues raised in terms of asthma and the environment lead to a collective form of illness experience, in which people with asthma make direct links to the social determinants of their health.

Air Pollution↗

Critical reflections on the politics of need: implications for public health.

This paper presents a case for an underlying language of need consistent with public health's commitment to social justice. After examining the problem of human need as it has been conceptualised historically, this paper argues that the problems of needs--a central concern in the modern welfare state--are inherently political. Two ways of conceptualizing need which have dominated the recent discourse on need--namely a therapeutic language of need and rights talk--are examined and found to be unsatisfactory in capturing the sense in which needs and their definition and arbitration are central to the life of the community. What is required for public health is a language of need which speaks to the reciprocity and interdependence which characterise community; such a language is to be found in a "moral economy of interdependence". The paper concludes by discussing what a moral economy of interdependence, as a language of need consistent with the aims of public health, might look like.

Canada↗

The politics and ethics of human embryo and stem cell research.

There is great promise for stem cell research to develop cells and tissues for transplantation and treatment of diseases such as Alzheimer and Parkinson disease, diabetes, and heart problems. There is also promise to advance understanding and treatment of cancer and congenital defects. Human embryo research is fundamentally the only way to understand human fertilization, implantation, and early development. For years, federal funding of human embryo research has been held hostage to a congressional prolife agenda. Any reasonable solution to these political disputes that so greatly affect women's reproductive interests and the promise of health benefits from embryo and stem cell research should mandate that governmental sponsorship proceed.

Abortion, Legal↗

Embryo and stem cell research in the USA: a political history.

Embryo and stem cell research in the USA is inextricably linked with the abortion debate. Since 1973, when elective abortions became legal, the government has refused to fund therapeutic research for fear it would encourage abortions. Research has continued in an unregulated private sector. Here, the unique US cultural, political and religious factors that have resulted in this situation are discussed.

Abortion, Induced↗

Changes in the biological status of Polish girls from a rural region associated with economic and political processes in the period 1967-2001.

The age at menarche, body height and weight of the daughters of farmers, farmer-workers and landless villagers in a rural region of Poland were studied. In the period 1967-1977, a time of economic development, a decrease in age at menarche (by 0.74 years) and a secular trend in body height (by 2.4 cm/decade) was observed. In 1977-1987, a period of acute economic crisis, age at menarche increased by 0.16 years and the secular trend in body height was only 1.1 cm/decade. In 1987-2001, age at menarche decreased and body height increased by 0.28 years and 2.9 cm respectively. The percentage of families owning a car, freezer and video increased during this period. These last results are indicative of an improvement in living conditions, but the villagers regard themselves as losers as a result of the political transformation (1989) in Poland.

Adolescent↗

Tarantism, dancing mania and demonopathy: the anthro-political aspects of 'mass psychogenic illness'.

This study questions the widely held assumption that the phenomenon known as mass psychogenic illness (MPI) exists per se in nature as a psychiatric disorder. Most MPI studies are problematical, being descriptive, retrospective investigations of specific incidents which conform to a set of pre-existing symptom criteria that are used to determine the presence of collective psychosomatic illness. Diagnoses are based upon subjective, ambiguous categories that reflect stereotypes of female normality which assume the presence of a transcultural disease or disorder entity, underemphasizing or ignoring the significance of episodes as culturally conditioned roles of social action. Examples of this bias include the mislabelling of dancing manias, tarantism and demonopathy in Europe since the Middle Ages as culture-specific variants of MPI. While 'victims' are typified as mentally disturbed females possessing abnormal personality characteristics who are exhibiting cathartic reactions to stress, it is argued that episodes may involve normal, rational people who possess unfamiliar conduct codes, world-views and political agendas that differ significantly from those of Western-trained investigators who often judge these illness behaviours independent of their local context and meanings.

Anthropology, Cultural↗

The politics of a scientific meeting: the origin-of-AIDS debate at the Royal Society.

The Royal Society of London held a scientific meeting in September 2000 focusing on two theories of the origin of AIDS: one, that it occurred through "natural transfer" of immunodeficiency virus from monkeys or chimpanzees to humans; and the other, that it occurred through iatrogenic transfer via contaminated polio vaccines used in Africa in the late 1950s. This meeting was the culmination of years of public contention over the polio-vaccine theory. Several dimensions of the politics of science are revealed by analysis of this issue, including the power of scientific editors, the use of the mass media, decisions regarding selection of speakers and organization of the meeting, and epistemological assumptions made by participants.

Acquired Immunodeficiency Syndrome↗

Trust, emotion, sex, politics, and science: surveying the risk-assessment battlefield.

Risk management has become increasingly politicized and contentious. Polarized views, controversy, and conflict have become pervasive. Research has begun to provide a new perspective on this problem by demonstrating the complexity of the concept "risk" and the inadequacies of the traditional view of risk assessment as a purely scientific enterprise. This paper argues that danger is real, but risk is socially constructed. Risk assessment is inherently subjective and represents a blending of science and judgment with important psychological, social, cultural, and political factors. In addition, our social and democratic institutions, remarkable as they are in many respects, breed distrust in the risk arena. Whoever controls the definition of risk controls the rational solution to the problem at hand. If risk is defined one way, then one option will rise to the top as the most cost-effective or the safest or the best. If it is defined another way, perhaps incorporating qualitative characteristics and other contextual factors, one will likely get a different ordering of action solutions. Defining risk is thus an exercise in power. Scientific literacy and public education are important, but they are not central to risk controversies. The public is not irrational. Their judgments about risk are influenced by emotion and affect in a way that is both simple and sophisticated. The same holds true for scientists. Public views are also influenced by worldviews, ideologies, and values; so are scientists' views, particularly when they are working at the limits of their expertise. The limitations of risk science, the importance and difficulty of maintaining trust, and the complex, sociopolitical nature of risk point to the need for a new approach--one that focuses upon introducing more public participation into both risk assessment and risk decision making in order to make the decision process more democratic, improve the relevance and quality of technical analysis, and increase the legitimacy and public acceptance of the resulting decisions.

Affect↗

Trauma severity and initial reactions as precipitating factors for posttraumatic stress symptoms and chronic dissociation in former political prisoners.

This study explores the relationships among trauma severity, initial trauma reactions, posttraumatic stress disorder (PTSD) symptoms, and dissociation in a group of 98 former East-German political prisoners. Trauma severity and initial reactions were assessed using a persecution checklist and a coping process questionnaire. PTSD symptoms were assessed through a structured clinical interview. Chronic dissociation was evaluated using the Dissociative Experiences Scale. The two assumptions of the study were confirmed by structural equation modeling: (1) Lifetime PTSD symptoms were predominantly predicted by initial reactions to trauma and (2) chronic dissociation was predominantly predicted by trauma severity. The first finding is discussed in relation to the participants' initial trauma processing. The second finding is discussed especially in the context of trauma duration and dissociation-prone coping attempts. Limitations concerning the long-term interval between traumatization and data collection are discussed.

Adaptation, Psychological↗