How are nations trying to prevent suicide? An analysis of national suicide prevention strategies

Recent increases in suicide rates internationally have focused attention on suicide as an important area of public health concern. In this review, strategies developed by various countries to halt this trend are compared. Nine out of 15 countries respond to enquiry about the state of development of suicide prevention strategies and programmes. Comprehensive strategies have been or are being developed by Finland, Norway, Australia, New Zealand and Sweden. The organization of these strategies differs between countries. The interventions have similar targets and are presented in detail. There are some similarities in strategy content but evident differences in organization. Further developments should not only be based on research, but also consider the diverse experiences of other countries, and they should incorporate appropriate structures for monitoring and evaluation.     

Radiotherapy in the treatment of low-grade astrocytomas

Between 1954 and 1986 inclusive, 160 children in the North West Region of England were registered with histologically proven lowgrade astrocytomas (grade 1 or 2). Ten died before receiving any treatment, and a further seven died within 28 days of surgery, leaving 143 children whose survival in relation to treatment modality is the subject of this paper. Low-grade astrocytomas are responsive to radiation therapy. This treatment has no clear benefit to offer children with superficial tumours that can be resected completely or nearly so, but significantly improves survival rates when tumours are deep-seated and not amenable to excision.     

Rheumatic heart disease and school screening: initiatives at an isolated hospital in Tonga

A simple and inexpensive assessment of cardiac murmurs and school health problems was conducted in an isolated island in the kingdom of Tonga. The prevalence of rheumatic and congenital heart disease in the population of 'Eua was 0.5% and 0.15%, respectively. The incidence of rheumatic heart disease for 1985 was 0.8 per 1000 population. The screening of 1106 students, who were aged five to 12 years, showed skin disease to be the most important problem. All identified cases were treated and referred for follow-up. The total cost of this study was US $281.48. This exercise demonstrated an alternative approach to maximizing the use of health resources as well as maintaining the skill and morale of health workers in isolated areas.     

A study of the value of electrophoretic and other techniques for typing Acinetobacter calcoaceticus

Forty-four isolates of Acinetobacter calcoaceticus var anitratus collected during hospital outbreaks were studied using polyacrylamide gel electrophoresis (PAGE), plasmid analysis, antibiograms and biochemical tests to determine their degree of similarity. Reproducibility tests were also carried out on the PAGE and biochemical techniques to determine their validity when used to compare bacteria of the same type isolated intermittently. PAGE data was analysed densitometrically and isolates compared using a similarity matrix. All methods were able to subdivide the isolates, but results did not always correlate well between methods. Reproducibility data indicated that careful attention to technique is required when organisms are examined by PAGE sequentially. Results suggest that no single biotyping technique is likely to be adequate and that electrophoretic, biochemical and antibiogram data may complement one another and other epidemiological data in the typing of these organisms.     

Axial rotation in the lumbar spine and gaping of the zygapophyseal joints

Axial rotation and zygapophyseal joint gaping was studied using 12 human lumbar spines from individuals ranging in age from 14 to 75 years. Using weight and pulley tests and manipulative testing in a torque apparatus, the movement produced by twisting the spine was found not to be pure axial rotation, but rather movement coupled with various combinations of lateral bending and flexion or extension. This motion may not be possible in testing an individual mobile segment. The twisting movements of the spine do not normally produce gaping of the zygapophyseal joints. These joints adapt to the axial rotation by the compliance of their articular cartilages and the movement of fat pads in and out of the joint capsule. Hypermobility appears to be associated with evidence of damage to part of the mobile segment, suggesting that the hypermobility (gaping) at a joint could be due to instability caused by injury.     

Bile acid receptors in colorectal cancer

Bile acids are thought to be involved in both the aetiology and development of colorectal cancer. In this study the existence of specific bile acid receptor proteins has been postulated. A receptor assay which involved labelling with 14C-deoxycholic acid was performed as well as autoradiography using 3H-deoxycholic acid. In an initial study resected colorectal cancer and adjacent histologically normal colorectal mucosa from 39 patients were studied, as were samples of normal gastric mucosa, cancers and benign colorectal tumours. Specific receptors to deoxycholic acid were detected in 12 (30.8 per cent) of the colorectal cancers, but in only 1 (2.6 per cent) of the samples from normal colorectal mucosa (X2 = 11.16, P less than 0.005). No deoxycholic acid receptors were detected in any other tissue studied. Autoradiographs of colorectal cancers showed binding of 3H-deoxycholic acid in receptor-positive tumour tissue. These findings might provide some explanation for the evidence linking bile acids with the disease.