Accidental Communities: Race,Emergency Medicine,and the Problem of PolyHeme®

This article focuses on emergency medical care in black urban populations, suggesting that the classification of a “community” within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between “autonomy” and “community.” The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines a clinical trial for the blood substitute PolyHeme^® (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of “community.” The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment.     

A clinical trial of continuous, intermittent and overlearning ‘bell and pad’ treatments for nocturnal enuresis

Sixty-one enuretic children were allocated sequentially to ‘standard’, ‘intermittent’ or ‘overlearning’ bell and pad treatment. The results suggest that the ‘overlearning’ modification of standard treatment was successful in bringing about a reduction in the relapse rate. The present status and implications of research into nocturnal enuresis were discussed in the light of the results of the investigation.     

Sexual identity and choice of sexual object: From bisexuality to implicate order

Abstract

Stensson J. Sexual Identity and Choice of Sexual Object: From Bisexuality to Implicate Order. Int Forum Psychoanal 1992; 1:93-97. Stockholm. ISSN 0803-706 X

Freud's concept of bisexuality leads to contradictory consequences. Seeing choice of sexual object in the light of unconscious primal phantasies as coding systems, unfolds new possibilities. Taking the primal scene phantasy as a preconceptual code for mature sexuality, I make a limited and preliminary attempt to outline some possible outcomes of interactions between primal scene and oral phantasies, taking help from the theoretical physicist David Bohm's ideas on implicate order.