Ethics, medicine and society: imperatives for the future

Historically, medicine has been a caring profession and social factors have directly and indirectly affected clinical practice, yet the social roots of disease and suffering in patients and the ethics of patient care have often been left out of medical teaching and discussions at medical conferences. As health and social problems are inseparable, ethically, medicine and medical teaching need to respond to social suffering, and should help to solve the economic problems in health care. Further, since all intervention in the lives of human beings carries ethical content through the nature of care, ethical competence involving ethical analysis, critical thinking, and problem-solving should be developed in medical students and doctors simultaneously with clinical judgement and expertise.(AU)

Detection of dengue infection in patients being investigated for leptospirosis in Barbados

Leptospirosis in endemic in Barbados, with an annual incidence of approximately 13 cases per 100,000 of the population admitted to hospital. The peak incidence occurs in October to December of each year, coinciding with the months of heaviest rainfall. During the second half of 1995 there was an epidemic of dengue type I infection, with almost 1000 laboratory-confirmed cases. During the same period, the mortality rate due to leptospirosis was twice the average. It is postulated that some cases of leptospirosis were being mis-diagnosed as dengue during the early stages of infection. A retrospective analysis of sera from patients investigated for leptospirosis was done to determine whether dengue was being mis-diagnosed as leptospirosis. Patients entered into a protocol for diagnosis of leptospirosis were studied if the first sample was collected during the months of July to December in the years 1995 to 1996. During 1995 and 1996, respectively, 27/106 and 22/65 patients were confirmed as having leptospirosis. The remaining sera from 79 and 43 leptospirosis-negative patients were tested for IgM antibodies to dengue virus, using a monoclonal antibody capture ELISA (MRL Diagnostics, CA). The results concluded that dengue fever may be under-diagnosed during non-epidemic periods. (AU)

Gender and age variations in the self-image of Jamaican adolescents

The purpose of the study was to investigate the relationships among gender, age, and self-image of adolescents attending three secondary schools in Jamaica. The relatively few studies that have been done regarding self-perceptions of these youths are not only dated but have utilized a unidimensional conceptualization of the self. The Offer Self-Image Questionnaire which employs a multidimensional construct of the self was administered to a sample of 174 Jamaican adolescents ranging in age from 14 to 18 years (M=15.90 years, SD=1.21). Results revealed statistically significant effects for both gender and age. Gender was found to be significant on one self-image dimension: Morals, while age differences were evident on six dimensions: Social Relationships, Morals, Sexual Attitudes, Mastery of the External World, Vocational and Educational Goals, and Emotional Health. The results in some instances were contrary to those of past research. Discussion focused on cultural socialization and other factors affecting youth in Jamaican society.(Au)

Common sexually transmitted diseases in clients under twenty and sexually abused children attending the Comprehensive Clinic, Kingston. A study of knowledge, attitudes and practices of new clients and repeaters

Today, health officials throughout the globe are concerned about the present trend of the sexually transmitted diseases (STDs). This study was carried out with the aims of eliciting common STDs in clients under twenty and in sexually abused children attending the Comprehensive Clinic, Kingston. Other aims were to assess the knowledge, attitudes and practices of new and old clients relating to STD infection. 140 clients 14 years and over were interviewed by questionnaire, while information on clients under 14 years was obtained from medical records in 13 cases. Results showed that the three prominent STDs affecting this age group are gonorrhoea, syphilis and NSU/NGU. Even though knowledge of the two common diseases gonorrhoea and syphilis was good, clients lacked knowledge about other STDs. The study revealed that there is a brand new attitude towards sexual morality among young people. The use of ganja was found to be a factor influencing recurrence while the use of unauthorised treatment was not a serious problem. The study identified two males under 14 molested by older females. Recommendations included the formation of health clubs, health education for the public and special programmes for constant repeaters (AU)