Doctors in Extremity

Book Reviews in This Article:
Robert Jay Lifton, The Nazi Doctors: Medical Killing and the Psychology of Genocide.
Eric Stovcr and Elena O. Nightingak, eds., The Breaking of Bodies and Minds: Torture, Psychiatric Abuse and the Health Professions.
Elliot S. Valenstein, Great and Desperate Cures: The Rise and Decline of Psychosurgery and Other Related Treatments for Mental Illness.     

Family Context and Childhood Adjustment Associated with Intrafamilial Unwanted Sexual Attention

Unwanted sexual attention (UWSA) encompasses unsolicited verbal comments, gestures, stares, and other noncontact behaviors made regarding one's sexuality and physical appearance. The present study examined the correlates and impact of such UWSA perpetrated toward girls by family members. The first objective of the study was to explore whether family climate is associated with intrafamilial UWSA. This included looking at three types of dysfunctional parenting styles (unaffectionate, unavailable, and patriarchal) as well as exploring the co-occurrence of UWSA by adult and child relatives. The second objective was to then measure the impact of such intrafamilial UWSA on childhood emotional health, after controlling for parenting style and the experience of more traditional forms of child sexual abuse (CSA). Of the 296 university women (mean age = 19) who participated in the study, 70% (N = 206) reported UWSA from a family member prior to age 18. Whereas each dysfunctional parenting style was related to presence of UWSA, a simultaneous multiple regression analysis indicated that two of the parenting styles, patriarchal and parental unavailability, also predicted frequency of nonphysical UWSA within the family. Presence of UWSA from a child relative was significantly correlated with presence of UWSA from an adult relative. Additionally, a hierarchical multiple regression, entering the three parenting styles simultaneously in the first step, childhood sexual abuse in the second step, and familial UWSA in the last step, indicated that the frequency of UWSA by family members significantly predicted poorer childhood mental health when controlling for the other variables. Overall, results indicate that while the specific parenting styles which co-occur with UWSA may be detrimental in their own right, the impact of UWSA on girls appears to be above and beyond that of either parenting styles or CSA. Clinical implications are discussed.     

Four Lessons for Developing Countries from the Trade Negotiations Over Access to Medicines

After the Agreement on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) came into operation in 1995 developing countries have found themselves in a process of continual negotiation over intellectual property rights and access to medicines. These negotiations have taken place in the World Trade Organization and in the context of free trade agreements. The paper suggests that the only real win for developing countries has been the Doha Declaration on the TRIPS Agreement and Public Health in 2001. What have been the lessons for developing countries in a decade of negotiations over access to medicines? Drawing on themes of rule complexity and regulatory ritualism the paper discusses four key lessons for developing countries. It concludes by arguing that developing countries will do better if they adopt a networked governance approach to negotiation rather than continuing to rely on traditional coalition formation.     

IDENTIFYING THE PSYCHOLOGICAL FACTORS THAT MEDIATE THE ASSOCIATION BETWEEN PARENTING PRACTICES AND DELINQUENCY*

Past research has largely ignored the developmental changes within the child that account for the association between parenting and risk for delinquency. We used structural equation modeling and data from a longitudinal study of several hundred African‐American families to test the contentions of various theories regarding the sociocognitive and emotional factors that mediate the impact of parental behavior on a youth's risk for delinquency. Our findings largely supported the theories. The impact of monitoring/discipline was indirect through low self‐control and acceptance of deviant norms, whereas the effect of hostility/ rejection was indirect through low self‐control, hostile view of relationships, and acceptance of deviant norms. These two dimensions of parenting were no longer related either to affiliation with deviant peers or to conduct problems once the effects of these psychological characteristics were taken into account; the impact of these parenting practices was completely mediated by these four cognitive/affective variables. Contrary to expectation, however, these psychological factors did not mediate any of the relationship between caretaker involvement in antisocial behavior and child conduct problems.     

The diagnosis of the mechanisms of bone tissue destruction from the surface of the break]

Data on bone tissue fractography are summarized and systematized. Possibilities of a microscopic fractography method in analysis of skeletal bone fractures in order to determine conditions of traumatic exposure were shown. Destruction of bone tissue is considered from the point of view of fragile and tough destruction using as a model solid body with crack at the top of which deformations of detachment, lateral and longitudinal shifts are acting. Morphologic features for different types of destruction were singled out. Use of these features may help to determine character and type of deformation at concrete areas of fracture during all destruction process.