The psychiatric targets set in 'The Health of the Nation' reflect a fundamental change in auditing the psychiatric and social services, and it is argued that suicide levels have become 'Paradoxical ...indicators' of effectiveness. Based upon mortality rates between 1974-1990, inter-regional comparative league tables are presented. Changes in age and gender patterns, and the accumulative impact of unemployment 1990-1994, especially in the more affluent regions, suggest that the suicide targets may not be feasible. The implications for the community and psychiatric services are briefly discussed.
Alpha Thalassemia Pritchard, Colin C.; Tait, Jonathan F.
Diagnostic Molecular Pathology in Practice
Book Chapter
A pregnant couple presented for evaluation of possible alpha thalassemia trait. Because both prospective parents were of Egyptian ancestry, routine screening for thalassemia trait was indicated. ...Hematologic testing showed that the mother was microcytic mean red-cell volume (MCV) 75 fL with a HbA2 fraction of 2.5% and a normal hemoglobin electrophoresis. The father had a similar picture (MCV 77 fL, HbA2 2.3%, normal hemoglobin electrophoresis). Iron studies were normal, and the normal HbA2 results effectively ruled out beta thalassemia trait. DNA testing for alpha thalassemia was therefore performed, but both parents were negative for six common deletional mutations that cause most cases of alpha thalassemia.