In the high court of South Africa,case no. 4138/98: the global politics of access to low-cost AIDS drugs in poor countries

In 1998, 39 pharmaceutical manufacturers sued the government of South Africa to prevent the implementation of a law designed to facilitate access to AIDS drugs at low cost. The companies accused South Africa, the country with the largest population of individuals living with HIV/AIDS in the world, of circumventing patent protections guaranteed by the intellectual property rules that were included in the latest round of world trade agreements. The pharmaceutical companies dropped their lawsuit in the spring of 2001 after an avalanche of negative publicity. Yet, despite the government's victory, AIDS drugs remain very expensive in South Africa, and the government still refuses to provide antiretroviral therapy to adults. These events have shone a spotlight, not only on the possibilities for coordinated political activism in the era of instant global communications, but also on the tangled social, economic, and political dimensions of AIDS treatment in poor countries.     

Recollection deficits in dysphoric mood: an effect of schematic models and executive mode?

Depression and dysphoric mood states are often accompanied by quantitative or qualitative shifts in performance across a range of retention tasks. This study focuses on the recollection of both autobiographical events and word lists in dysphoric states. Recollection occurs when people are aware of some contextual detail allied to the encoding experience. This study establishes the presence of a recollection deficit in dysphoria in two distinct paradigms. In both autobiographical recall and in recognition memory, recollection in a dysphoric group was at lower levels than recollection in matched controls. The study examines the hypothesis that the extent of recollection is influenced by two factors: (1) the degree of differentiation of schematic mental models; and (2) the executive mode that predominates when memory tasks are carried out, with the latter assumed to be altered by rumination. The relationship between responses based on recollection and alternative mnemonic responses could be predicted by measures of these two factors. The results are discussed in terms of the Interacting Cognitive Subsystems model (Teasdale & Barnard, 1993) and the perspective it offers on the relationship between meaning systems and executive functions (Barnard, 1999).     

Bridging between basic theory and clinical practice

This paper articulates and discusses the parts played by different processes and representations in the overall conduct of applied clinical science. It distinguishes two sorts of representation, theories in the science base and bridging representations needed to map from real world behaviour to basic theory and from theory back to the real world. It is then argued that macro-theories of the "normal" human mental architecture could help synthesise basic theoretical accounts of diverse psychopathologies, without recourse to special purpose clinical cognitive theories of particular psychopathologies or even specific symptoms. Using the Interacting Cognitive Subsystems model [Affect, Cognition and Change: Re-modelling Depressive Thought, Lawrence Erlbaum Associates, Hove, 1993], some specific macro-theoretic variables are identified. Concrete illustrations are given of how the essence of quite complex basic theory can be translated into a simpler representational format to help clinicians conceptualise a psychopathological state and pinpoint relevant variables that might be changed by therapeutic interventions. Some suggestions are also offered about how the inevitable problem of complexity in multiple component theories might be directly confronted.     

The influence of early mother—child interaction on preschool cognitive/linguistic outcomes in a high-social-risk group

In this paper, elements of early mother—child interaction are related to later cognitive and linguistic outcomes in a sample of 53 high social risk mothers and their preschoolers. Mother—child interaction was observed longitudinally when the children were 13 and 20 months old. Multiple regression analyses were used to predict cognitive and linguistic outcomes at 3 and 5 years from measures of early mother—child interaction. The results indicated that the quality of early mother—child interaction was a significant predictor of preschool cognitive and linguistic outcomes. This was shown to be true regardless of the contribution of the mother's IQ.     

A collaborative effort to study mother—child interaction in three risk groups: Social risk mother,adolescent mother,preterm infant

This paper describes the collaborative efforts of three intervention projects with similar data sets on high-risk populations of mothers and their children at 13 and 20 months. The three projects collected data on a total of 190 dyads from three risk groups: adolescent mothers and their infants, high social risk mothers and their infants, and high social risk mothers and their preterm infants. The authors define the common set of measures and resulting variables used collaboratively to measure parent-child interaction and compare the three risk groups at both 13 and 20 months.     

Successful intervention with multi-problem mothers: Effects on the mother-infant relationship

A two-step model of intervention for multi-problem mothers was proposed. In order to improve mother-child interaction and later developmental outcomes, the first step is for the practitioner to help the mother change her external competencies (adult social skills) and internal perceptions (support, depression). These changes make the second step possible—the mother then can learn to foster her own child's development. The model was tested in a study of 95 multi-problem women who participated in a nursing intervention program from mid-pregnancy through the child's first birthday. The results supported the two-step model. Improvements in the mothers' external competencies were related to completion of intervention goals. These external improvements also were related to more optimal patterns of mother-child interaction during teaching and feeding episodes at 1 year. Furthermore, an especially insecure type of attachment relationship was found more frequently among the infants of mothers in the group that did not improve. Changes in internal perceptions were unrelated to intervention or interaction measures. These unexpected results suggest that the mother's internal improvements may have a more delayed or a less direct effect upon the child.     

Family Physicians and Family Therapists: Understanding the Interdependent Synergism

This article, written by a family physician and a family therapist, is designed to identify differences between these two cultures that may serve as stumbling blocks to successful meeting of occupants of these two worlds. With the differences identified and described, various notions and suggestions are offered in an effort to promote more successful bridging between these two groups. There is little question about the synergistic impact that can be engendered for recipients of their care should this bridging be successfully navigated. The present day realities in healthcare make this an idea whose time has not just come, but rather seems imperative.