Iatrogenesis and suicide in South African Indians

Psychological profiles were obtained by careful, structured interviewing of those who had been close to 47 consecutive South African Indian suicide victims who had died within the greater Durban area between 1982 and 1984, and whose deaths had been designated as 'suicide' by the magistrate conducting the inquest. Almost 50% of the subjects had been suffering from significant physical illnesses, and 65% were taking medication with the potential to potentiate depression. All were retrospectively diagnosed as having been depressed, as they had shown clear signs and symptoms of this illness, yet none was being treated for depression at the time of his or her death. Warnings that they were considering suicide were given by 68%, but little notice was taken. The implications for medical practice and training are discussed.

Medication as a potential cause of depression

Many different drugs have been reported to cause depression. The substantive literature is reviewed, with particular attention to antihypertensive and cardiac drugs, oral contraceptives, levodopa and major tranquilizers. The nature of the relationship between physical illness, therapeutic drug use and the potentiation or precipitation of depression is explored.

Education for life

I’ll do something rather dangerous today, and something very unusual for a major national expert in education. I’ll tell the truth about education. It’s not a pretty story, because it’s a story of murder. Soul murder; the persistent diminution of the natural spirit of inquiry; the solemn clipping of wings; nurturing bonsai brains, preparing not for growth and creation throughout life, but sedation for the long littleness of life. John Kenneth Galbrath once said: I f you can’t always comfort the afflicted — sometimes its useful to afflict the comfortable.

How to… Design and Use a Questionnaire in Evaluation and Educational Research

Questionnaires are a valuable way of collecting information and there is no doubt that a good design will help provide accurate and relevant data. This article discusses the points that contribute to a well-designed questionnaire and the steps that need to be taken in its preparation.

The use of elicited imitation as a measure of expressive grammar: a question of validity

Elicited imitation has been suggested as an alternative to Developmental Sentence Scoring (DSS) as a means of measuring grammatical performance. Numerous investigators, however, have demonstrated that short-term memory is a confounding variable during elicited imitation. In the first experiment the imitative skills of 4 year old were assessed as a function of sentence comprehension and delayed imitation. The second experiment examined the relationship between the Carrow Elicited Language Inventory (CELI) and DSS under three imitative conditions; 0, 3, and 5 second delays. Results indicated that subjects were able to accurately repeat sentences which they did not understand as long as imitation was immediate. Delaying imitation 3 seconds adversely affected imitation of noncomprehended sentences while having no significant effect on comprehended sentences. A 3 second delay on the CELI also improved its correlation with DSS from -.77 (standard procedures) to -.90. The validity of elicited imitation as a test of expressive grammar is challenged.

Thermodynamic Studies and Magnetic Ordering of Ni-Cr Alloys Close to the Critical Composition

We report measurements of the specific heat capacity and the thermal expansion for Ni-Cr alloys in the vicinity of the magnetic ordering temperature TM and at lower temperatures. No evidence of a contribution due to the magnetic ordering is found in the specific heat capacity and only the indication of a small contribution in the thermal expansion near to T M for an Ni 11 at. % Cr alloy. A significant contribution of magnetic origin is seen for both quantities at lower temperatures. Values for the magnetic Grlineisen parameter yi, are derived from the specific heat capacity and thermal expansion data and compared with values of dIn TM/d In V obtained from direct easurements of dTM/dP. Both yi, and - d In TM/d In V are large and negative for weakly ferromagnetic alloys but differ numerically, whereas for paramagnetic alloys yi, is large and positive.

Death education--where is thy sting?

We are not free to choose whether anyone will learn about death, though we have some choice about how they will learn. The author discusses the basic questions that need to be answered in planning death education at any level, and the possible goals, in terms of cognitive gain, skills, and attitudinal objectives. Some principles in regard to teaching methods and evaluation are described, with illustrations from the experiences of medical students and others. It is important that the teacher should be able to deal with the problems that such programs may arouse. Cheap emotional arousal is easy to produce, but trivial, unless creatively used for a valued purpose and adequately resolved. Death is infinitely exploitable, and the growth of death voyeurism via "education" is alarming. The capacity to recognize and avoid being exploited or exploiting others must be one of our principle educational objectives.

WHO Has Got it Right: A New 16mm film M&B May&Baker Aspects of anaerobic infection

Hilaire Belloc wrote "They answered as they took their fees 'There is no cure for this disease.'" The profession to which he was referring is probably transparent, but what may be a little more opaque is that his comment could apply to those individuals who claim to run courses suitable for medical educators, including those who come from developing countries. However, for those who read the paper Progress of the WHO Global Teaching Training Programme 1969-1979 (WHO/EDUC/79.178), the truth of Belloc's words is as painful as Mark Twain's plea to "Always tell the truth because it will gratify the few and astonish the many."

The Problem with POMR

In this article, Dr Michael Simpson argues the case against unquestioning acceptance of problem orientated medical records, in reply to the article which appeared in the last issue of Medicd Teacher (1979, 1, 147-1511.

Spectrophotometric determination of lymphocyte mediated sheep red blood cell hemolysis in vitro

An assay has been developed in which the degree of in vitro spleen cell-mediated sheep red blood cell (SRBC) hemolysis is quantitated spectrophotometrically (QHS). Immune mouse spleen cells, SRBC and guinea pig complement were incubated at 37 degrees C for 1 h in buffer, centrifuged, and the supernatant solutions read at 413 nm. The greatest degree of cell-mediated SRBC hemolysis was observed in day +5 harvested spleens following a day 0, 5% SRBC i.p. injection. In the assay system, it was found that a stimulator SRBC dose of 0.2% resulted in maximal stimulation with little non-specific hemolysis. This assay is presented as an alternative to the well established plaque forming and rosette assays.

The phenomenology of self-mutilation in a general hospital setting

Comparison of a series of twenty-four wrist-cutters with a control group of self-poisoners showed a number of significant differences. The wrist-cutters were younger and their acts were regarded as being of low lethality; they are no more likely to have made previous suicide attempts; they complain less often of depression, and more frequently of 'emptiness' and tension as primary complaints. Sudden, unpredictable mood swings are common and there is a greater tendency for their physicians to diagnose personality disorders, often in pejorative terms. They frequently have substantial medical interests and paramedical occupations. A high proportion complain of dysorectic symptoms (anorexia or overeating or combinations of both), use drugs and/or alcohol in excess; show sexual disturbance and distress, and also promiscuity. They more frequently have a negative reaction to menarche and menstruation; have come from broken homes and have experienced parental deprivation. A proportion of the group exhibit difficulty in verbal communication, and absconding from hospital was more common in the group of cutters. Painless cutting after a period of depersonalization, followed by relaxation and repersonalization after bleeding, was the typical pattern.