Chronic disease and disadvantage: the new politics of HIV infection

HIV infection is now perceived as the end stage of a chronic disease that is spreading most rapidly among blacks and Hispanics. The politics of the HIV epidemic in the 1980s were dominated by four interacting factors: fear and fascination; who had the disease and to whom it seemed to be spreading; the endemic problems of United States social policy; and the impact on policy of advances in scientific knowledge. This paper analyzes the political history of each of these factors and describes the dominant policies of the federal government and the states regarding HIV in the areas of surveillance, prevention, research, and financing. Four uncertainties will have a profound influence on the future politics of the HIV epidemic: how the states and the federal government will address the general problems of paying for the care of people with chronic diseases and providing access to care for the uninsured and the underinsured; the number and distribution of the sexual behaviors that transmit infection with HIV and the effectiveness of policies to persuade people to modify these behaviors; precisely who uses addictive drugs and the effectiveness of measures to change their behavior; and the natural history of the virus.     

Sulfide concentrations in postmortem mammalian tissues

Postmortem changes in sulfide concentrations in body tissues were examined in autopsied rats exposed to hydrogen sulfide concentrations of 550 to 650 ppm, and in nonexposed rats and humans. Analyses were made by gas chromatography, following an extractive alkylation. Sulfide concentrations in the blood, liver, and kidneys of rats increased in both the exposed and nonexposed groups, depending on the lapse of time after death. On the other hand, the lung, brain, and muscle showed little or no change in sulfide concentration with elapse of time after death. The data obtained from human tissues were almost the same as those for rats, except data for blood, in which no or little increase of sulfide was observed.     

IS AGE IMPORTANT? TESTING A GENERAL VERSUS A DEVELOPMENTAL THEORY OF ANTISOCIAL BEHAVIOR*

We tested competing hypotheses derived from Gottfredson and Hirschis (1990) general theory and Moffitt's (1993a) developmental theory of antisocial behavior. The developmental theory argues that different factors give rise to antisocial behavior at different points in the life course. In contrast, the general theory maintains that the factor underlying antisocial behavior (i.e., criminal propensity) is the same at all ages. To test these competing predictions, we used longitudinal data spanning from age 5 to age 18 for the male subjects in the Dunedin Multidisciplinary Health and Development Study. Using reports from three sources (parents, teachers, and the boys themselves), we estimated second-order confirmatory factor models of antisocial behavior. These models provided consistent support for the developmental theory, showing that separate latent factors underlie childhood and adolescent antisocial behavior. Moreover, we found that these childhood and adolescent factors related in ways predicted by Moffitt's developmental theory to four correlates of antisocial behavior: Childhood antisocial behavior was related more strongly than adolescent antisocial behavior to low verbal ability, by per activity, and negative/impulsive personality, whereas adolescent antisocial behavior was related more strongly than childhood antisocial behavior to peer delinquency. The two underlying latent factors also showed the predicted differential relations to later criminal convictions: Childhood antisocial behavior was significantly more strongly associated with convictions for violence, while adolescent antisocial behavior was significantly more strongly associated with convictions for nonviolent offenses.     

Congressional Dominance and the International Trade Commission

This study examines the unfair trade decisions of the InternationalTrade Commission (ITC) and how they have been affected by Congress.It begins by identifying the means Congress can use to influenceITC decisions and then estimates both the extent to which thesemeans have been used and the extent to which they have shaped theITC's behavior. The study reaches two conclusions. First, Congresshas tried to shape the ITC's behavior, but it has not tried tomicromanage this behavior. Second, while the ITC's behavior hasbeen influenced by Congress, congressional influence is not asimportant as other factors, such as statutory criteria.     

Ethics and the Physician-Patient Relationship

Book Reviews in This Article:
Getting Rid of Patients: Contradictions in the Socialization of Physicians . By Terry Mizrahi
Physicians and Social Change . By John Colombotos and Corinne Kirchner
Changing Values in Medicine . Edited by Eric J. Cassell and Mark Siegler
Professional Ethics and Primary Care Medicine: Beyond Dilemmas and Decorum . By Harmon L. Smith and Larry R. Churchill
Physician—Patient Decision-Making: A Study in Medical Ethics . By Douglas N. Walton
With Dignity: The Search for Medicare and Medicaid . By Sheri I. David
The Dismissal of Students with Mental Disorders. Legal Issues, Policy Considerations, and Alternative Responses .
Courtroom Toxicology . By Marshall Houts, Randall C. Baselt, and Robert H. Cravey