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Adolescents with a history of conduct problems (CP) are at heightened risk of increased service utilization as they develop. While the mechanisms underlying this association are unclear, early CP have also been linked with peer victimization and internalizing problems. The goals of the current study were: (1) to examine peer victimization and internalizing problems as potential serial mediators explaining increased medical and psychiatric service use in adolescents with a history of childhood CP, and; (2) to explore whether the proposed mediation models vary by sex.
Methods
Participants (N = 744; 53% boys, Mage = 8.39 years) from an ongoing longitudinal study that began in 2008 in Québec, Canada were recruited and assessed for CP, service use, and other behaviours via self-, parent- and teacher-reported questionnaires. Serial mediation analyses were conducted to examine the effects of peer victimization and internalizing problems on the association between childhood CP and adolescent medical and psychiatric service use, controlling for sex and household income.
Results
Adolescents with childhood CP reported higher medical and psychiatric service use than non-CP peers. Peer victimization and internalizing problems significantly mediated this association in both general medical and psychiatric service use models. The models did not vary by sex.
Conclusions
Findings support higher levels of service use in adolescents with a history of CP, mediated by peer victimization and internalizing problems. Specifically, results highlight the importance of examining peer and socioemotional factors that may explain the increased service usage observed among youth with CP, to support better health outcomes.
Travis Chi Wing Lau addresses the place of race within Romantic-era medical discourse, calling attention to the disabling forms of experimentation on Black bodies that enabled anatomical research. There is, Lau points out, a key irony in these experiments, as the study of those who were understood to be fundamentally pathological led to universalizing conclusions about the nature of normative, white man. If this sounds like a moment of merely historical interest, Lau assures us it is not. Rather, the legacy of the racialized discourse of medicine can be witnessed in ongoing health disparities among differently racialized groups.
In the twentieth century, settler states have operated through science. At the same time, the field of American bioethics has safeguarded the moral authority of science. It has done so by upholding the settler logics of the sciences that it claimed to hold to account. This chapter explores how the imperial logic of American bioethics works – through its concepts, practices, and imperceptions. To do so, the chapter follows Carolyn Matthews, an everyday American with a rich “vernacular archive” and apt work experiences, across three medical sites and over three postwar decades. It tells Carolyn’s story in two registers – setting Carolyn’s work experience prior to 1974, when the US Congress passed laws for the treatment of human subjects, alongside Carolyn’s moral recounting of those work experiences in the late 1970s. Carolyn’s case offers insight into how the vocabulary and framework of modern American bioethics embeds a moral ontology organized around civic individualism and its safeguarding, as opposed to anticolonialism and its dismantling. The aim of this critique of bioethics through the Americas is to strengthen existing alliances for justice-based science and to inform anticolonial practices – in science, history, and transformative bioethics.
Investment banks collaborated with health care entrepreneurs and managers in the 1990s to add a costly layer of investor-owned corporations to the US medical delivery system. In capitalizing and consolidating physician practices, publicly traded Physician Practice Management Companies (PPMCs) incorporated elements of the broader capitalist economy. Companies such as PhyCor, MedPartners, and FPA Medical Management turned to the equity and debt markets to generate shareholder profits and capital for acquisitions. Contemporary theories of financial economics reinforced their activities. PPMCs collapsed after shareholder lawsuits accused them of reporting false figures to the SEC and banks withdrew their credit. Physicians were both accomplices and victims in the process that made the medical delivery system less equitable, less effective, and more expensive. Although this experiment in medical capitalism failed, it widened the door for Wall Street to build new ways to profit from health care.
Chapter 2 explores accounts by Civil War nurses and surgeons – first-person nonfiction, lightly fictionalized narrative, sensationalized memoir, and fiction. The central texts in this chapter are Walt Whitman’s Memoranda after the War, Louisa May Alcott’s Hospital Sketches, John Brinton’s Personal Memoirs, Susie King Taylor’s Reminiscences of My Life in Camp, and S. Weir Mitchell’s “The Case of George Dedlow.” These narrators represent amputation in different ways, especially the scene of amputation itself, the image of a basket or trough of dismembered limbs, and amputee reflections on the relationship between their remaining bodies and their absent limbs. However, for all the narrators in these texts, amputation is part of a meditation on the meanings of intact and amputated bodies, and their role in making sense of the Civil War. The chapter ends with a discussion of the Army Medical Museum, in which amputated limbs were catalogued, stored, and displayed as examples of the damage done by gunshots and shells. This dovetails with a reading of George Dedlow, in which the protagonist’s legs, stored in alcohol at the Museum, return to him briefly during a séance, absurdly marrying hopes for bodily resurrection with spiritualism’s belief in a humanized heaven.
Ensuring the future of France – its children – meant fighting on multiple dimensions. One set of enemies included infectious diseases, especially tuberculosis and the influenza pandemic; the other set comprises illnesses and infant mortality attendant to poverty and malnutrition. Thousands of volunteers from the United States fought these battles with treatment and prevention strategies. They toured the Franco-American colonies, organized large antiepidemic campaigns, and produced leaflets providing practical advice on managing the care of babies and children during wartime. With the help of the Children’s Bureau of the American Red Cross, the American Commission for the Prevention of Tuberculosis in France, and the Rockefeller Foundation’s International Health Division, thousands of leaflets were distributed to the Franco-American colonies of the CFAPCF, fatherless children supported through the FCFS, as well as to schools and mothers across France. With the spread of tuberculosis in 1917 and the 1918 influenza pandemic, American medical experts realized that a sanitary ironclad was needed to block the spread of contagious diseases to the United States: to protect France was to protect the United States.
This chapter provides an overview of how various aspects of sexuality are dealt with in different Islamic traditions. If first looks at the Qur'an, the Sunna and pre-modern Islamic legal sources. It then focuses on how some medical and erotological sources dealt with the issue in the past, and finally looks at how contemporary feminists are pushing back against patriarchal interpretations of Islamic traditions. The chapter argues that pre-modern texts can help explain how sexuality is understood in contemporary Muslim-majority societies, where continuities are as striking as ruptures, especially when coming to religious or legal sources. It also reminds us of the danger of essentialism, oversimplification and lack of historical contextualization when looking at Islamic and religious traditions in general.
This chapter examines the relationship between Black literature and anti-Black medical violence. It argues that, since at least the eighteenth century, Black writers have tapped into the narrative and documentary power of Black writing to chronicle and archive the racialized operations of medical violence and its historical attempts to exploit Black bodies. Using literature to spotlight medicine’s role in the global economies of Black embodied terror, these writers have helped to construct an important site of memory that I call the Black medical archive. In doing so, they demonstrate the importance of medicine to the politics and aesthetics of the Black literary tradition, from its origins to the present. Further, they unfurl how Black literature has long been a crucial site for the transformational practices of storytelling that the field of narrative medicine has proffered as a radical intervention into the histories of violence, exploitation, and discrepant care that have informed the practices and epistemologies of modern medicine.
For Swift, sickness and health were personal, moral, and political. This chapter focuses on Swift’s articulation of disgust, in particular the disgust towards the female body that readers encounter in poems such as ‘The Lady’s Dressing Room’ (1732) and ‘A Beautiful Young Nymph going to Bed’ (1734), as well as Gulliver’s revulsion at the monstrous Brobdingnagian breast. Swift depicted a sickeningly dirty world for a culture and class for whom politeness, civility and refinement were associated with cleanliness. In their own disgust and repulsion at Swift’s filthy rudeness, readers resist his satire’s collapse of dichotomies. The moral and the physical converge in his work as antinomies of health and sickness collide with oppositions of purity and filth.
During the nineteenth century, singers had a range of literature available to them for instruction on how to take care of their voice. This literature included the autobiographies and biographies of singers, works by quacks and doctors, recipes, and advertisements. This article demonstrates the degree to which all of this literature potentially played in the promulgation of health regimes for singers to keep their voice in the best possible working order. The article argues that these health regimes were likely based on superstition or medical advice (or both) and operated within a larger context of narratives pertaining to public health throughout the nineteenth century ranging from the need for breathing in quality air to taking certain kinds of baths. The article charts the oral and print sources through which singers took advice on vocal health and hygiene.
What changes in the conceptualization of God, the ultimate healer, once God himself becomes the object of healing? This article examines the delicate tensions between divine and human agency in the Lurianic kabbalah, focusing on its grammar of action, and the complex relations between the subjects and the objects of this action. Rather than analyzing the relations between the kabbalists and their God through their conscious perceptions, the article explores how these relations emerge from the Lurianic discursive configurations and describes the role of medical discourse in their shaping. I claim that in order to perceive the transformation in the image of God in this early modern kabbalistic corpus, we should place at the heart of our inquiry the questions of who the patient is in the Lurianic medical clinic and how the relations between the human and the divine protagonists of the Lurianic drama are woven in this clinic.
This chapter explores the contours of illness and embodiment in medical lexicography. From the early modern period, dictionaries subjected sexual deviance to medical as well as legal and moral regulation, as abominable acts were linked with aberrant anatomies. While hard-word and general dictionaries offered cautionary tales of hypospadians committing bestiality and sodomites afflicted with anal disfigurements, specialist medical lexicons were far more preoccupied with women who had sex with women. Lexicographers endowed these tribades or confricatrices with preternaturally large clitorises which they used to have penetrative sex—though whether clitoral enlargement was the cause of tribadism or its consequence was a question whose answer varied from one author to the next. That dictionaries aimed at physicians were able to dissect women’s sexuality with such candour prompts us to consider the exclusivity of medical lexicography in both social and material terms: with respect to the barring of women from the elite medical professions until the late nineteenth century, and to the escalating price of specialist works compared to the cost of dictionaries aimed at lay users.
This chapter samples health-related signs, including several public service announcements from past pandemics, medicines, and various offices and departments in a neighborhood community clinic in Shanghai.
This Element considers current legal, ethical, metaphysical, and medical controversies concerning brain death. It examines the implicit metaphysical and moral commitments and dualism implied by neurological criteria for death. When these commitments and worldview are not shared by patients and surrogates, they give rise to distrust in healthcare providers and systems, and to injustice, particularly when medicolegal definitions of death are coercively imposed on those who reject them. Ethical obligations to respect persons and patient autonomy, promote patient-centered care, foster and maintain trust, and respond to the demands of justice provide compelling ethical reasons for recognizing reasonable objections. Each section illustrates how seemingly academic debates about brain death have real, on-the-ground implications for patients and their families.
Aztecs were brilliant scientists, writers, and artists. Medicine is an example of their scientific activities. They developed ideas about the causes of illness, practical and supernatural. Priests and priestesses were involved in curing, but Aztecs had an array of healers. The most commonly used term by Aztecs for a doctor – someone with specific and practical knowledge about healing – was “ticitl,” female and male. That Aztecs wrote is not widely recognized. They used writing to name people, titles, places, and deities. Not merely pictography, their writing is complex and developed from the late prehispanic period into the colonial period. Their books recorded calendars, history, tribute payments, and succession to rulerships. They also created a rich oral literature, often expressed through songs. Many were ancient, others composed in the early colonial period. Those that became written in alphabetized Nahuatl dealt with deities, temples, flowers, lords, war, sexuality, even conquest and Christian worship. Also great artists, they were influenced by the art of earlier peoples and the Mixteca-Puebla style and worked in several media: architecture; monumental and small-scale stone sculptures; books; precious stones and gold work; textiles; dough sculptures; and paper. This art expressed an official ideology as well as resistance to it.
Looking at French writer Édouard Louis’s oeuvre – including En finir avec Eddy Bellegueule (The End of Eddy) (2014), Qui a tué mon père (Who Killed My Father) (2018), Changer: Méthode (Change: Method) (2021), Combat et Métamorphoses d’une femme (Battles and Metamorphoses of a Woman) (2021), and Dialogue sur l’art et la politique (Dialogue on Art and Politics) (2021) – this chapter analyses the relationship between (white) working-class/poor individuals and medicine, masculinity and care. This study sheds light on Louis’s strategy to deploy a ’democracy of care’ – that is, a type of social organization grounded in equality, more horizontal relations, and which values care (and care workers) over economic production – by using his artistic practice to draw attention to lived experiences of trauma, pain, silence, and social invisibilization. Further, it does not only appear that Louis’s writing about pain serves to reflect on France’s healthcare policies and inequalities, but also that power dynamics (such as patient-doctor) inform his writing practice.
Despite progress, discrimination in public health remains a problem. A significant aspect of this problem relates to how medical resources are allocated. The paradigm of quality-adjusted-life-year (QALY) dictates that medical resources should be allocated on the basis of units measured as length of life and quality of life that are expected after the implementation of a treatment. In this article, I discuss some of the ethical shortcomings of QALY, by focusing on some of its flawed moral aspects, as well as the way it relates to discrimination on the basis of age, race, and disability status. I argue that while this approach seeks to maximize efficiency, it does not place sufficient value on the preservation of life itself. Even more concerning is the fact that the use of QALY disproportionately harms minorities. While QALY is a well-intentioned approach to the allocation of scarce healthcare resources, new alternatives must be sought.