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Biomedical subjects

E S Nash

Publications and source records attributed to E S Nash.

At least 19 recordsLinked to original sources
PubMed1992

South African psychiatrists' attitudes to the present implementation of the Abortion and Sterilisation Act of 1975.

In 1980 and 1990 reports were published in the SAMJ on the attitudes of South African gynaecologists to the present Abortion and Sterilisation Act of 1975. The proportion of respondents favouring abortion on demand in the first trimester rose from 32% to 40% over this period, while that of respondents requesting a review of the Act increased from 71% to 85%. The Society of Psychiatrists of South Africa decided to conduct a similar survey of its members using the same questionnaire with some additional questions on current psychiatric practice. Of the 50% of psychiatrists who responded, 78% were personally involved in the implementation of the Act. Some 51% of psychiatrists supported termination on request before the 12th week of pregnancy, an equal number felt that the role of psychiatrists in the implementation of the Act should be reduced, and 89% considered that the present Abortion and Sterilisation Act requires review. Thus, many psychiatrists and gynaecologists are seeking a revision of existing legislation on the medical termination of pregnancy.

Abortion, Induced↗
PubMed1992

The therapeutic sterilisation of the mentally handicapped. Experience with the Abortion and Sterilisation Act of 1975.

The Abortion and Sterilisation Act of 1975 gives legal sanction for the sterilisation of persons with a mental handicap, and by 1989, 1,817 such persons had been sterilised in South Africa. In this paper, we review our experience in investigating all 291 persons who were referred to the Pregnancy Advisory Service of Groote Schuur Hospital for this purpose. Referrals included 37 white, 233 coloured and 21 black patients. One hundred and eight (37.1%) were severely retarded, 104 (35.7%) were moderately retarded, 70 (24%) were mildly retarded and 9 (3.2%) were not testable. None could give informed consent and the applications for sterilisation came from burdened families of whom one-third were already caring for illegitimate children born to these mentally handicapped women. Of the 291 applications, 231 (79%) were recommended for sterilisation. The main issues involved in making a decision to sterilise mentally retarded individuals are the valid assessment of the degree of retardation, the availability of alternative means of fertility control, and the complex ethical factors that have to be considered with regard to the sterilisation of persons with a mental handicap.

Adolescent↗
PubMed1991

Cancrum oris-like lesions.

Cancrum oris is predominantly seen in children in underdeveloped countries where widespread malnutrition, dehydration and epidemic infections are present. In the western world, it is sometimes found in immunosuppressed adults with predisposing conditions such as leukaemia and infection associated with malnutrition. Early diagnosis and an intensive therapeutic approach are the key to a favourable prognosis of noma-like necro-ulcerative lesions. The prognosis is significantly improved if the predisposing condition can be removed. Two cases are presented and the treatment is discussed.

Ampicillin↗
PubMed1990

Teenage pregnancy--need a child bear a child?

International and local evidence suggests that the incidence of unplanned pregnancy in teenage girls is unacceptably high. Obstetrical concerns centre around insufficient antenatal care; paediatric on small babies vulnerable to neglect from child-mothers and burdened grandmothers; and psychiatric and social on the trap for ill-educated, unskilled, immature child-mothers, poorly equipped to face the demands of the modern world. The experience of assessing local teenagers for therapeutic abortion on psychiatric grounds is presented. Of the 187 girls of 16 years and younger who were seen, 67 (35.8%) were granted an abortion: the remainder were counselled about alternatives. A variety of interventions are discussed: medical, educational, social and legal. These need to be comprehensive in order either to prevent pregnancy or to promote the health of a child-mother and her vulnerable infant. The role of the psychiatric services in this context needs revision.

Adolescent↗
PubMed1985

Perspectives on anxiety.

An overview of the concept of anxiety from various perspectives, ranging from the biological through the psychological to the sociocultural, is presented.

Anxiety↗
PubMed1985

Hypertension in the aged--psychosocial and psychiatric concomitants in a coloured community.

In a comprehensive social, psychiatric and medical survey of a random sample of aged coloured people in Cape Town, 82% were found to be hypertensive. Hypertensive subjects were compared with non-hypertensive subjects in terms of various psychosocial and psychiatric factors. A significant association between hypertension and symptoms indicative of nervous tension was found. The roles of sex distribution, class and ethnicity as contributing factors are discussed.

Black or African American↗
PubMed1983

The coloured elderly in Cape Town--a psychosocial, psychiatric and medical community survey. Part III. A survey of physical disorders and disabilities.

A representative sample of elderly Coloured persons (over the age of 65 years) in the community underwent a medical and psychosocial assessment of prevalent physical disorders and resultant disability. This revealed that hypertension, visual impairment, osteo-arthritis and chronic lung disease were the most prevalent and disabling conditions, while hearing impairment and major neurological disorders played a lesser role. Most of the individuals claimed that they had little or no disability, while 10 felt they were only moderately disabled and 21 (14,9%) that they were severely disabled. The number of disorders ranged from 2,08 in those claiming no disability to 3,28 in those who were severely disabled. Profiles of the results of biochemical investigations resembled those of other aged populations, serum cholesterol, creatinine and alkaline phosphatase levels being raised. The pattern of medical care was also examined, including medication and the use of local facilities.

Black or African American↗
PubMed1979

Medical student training in doctor-patient communication.

Basic theories on doctor-patient communication as taught in the course on human behaviour to third-year medical students at the University of Cape Town are outlined, and it is shown how these are understood and used by medical students early in their clinical training. It is on these foundations that the later training in psychiatric interviewing and therapeutic intervention is based. The goal is to train the doctors of tomorrow to care for patients with physical and psychological distress equally effectively.

Communication↗
PubMed1978

Therapeutic abortion on psychiatric grounds. Part II. The continuing debate.

Over the past few decades, attitudes towards therapeutic abortion have gradually changed in many countries from denial and punishment to acceptance. The debate on this emotionally laden subject still continues. In this article, we review some of the recent literature covering therapeutic abortion on psychiatric grounds, including studies of women granted termination as well as those refused. Other related areas, such as the long-term effect on children born after the refusal of termination and the relevance of this to preventative psychiatry, are also considered.

Abortion, Legal↗
PubMed1978

Therapeutic abortion on psychiatric grounds. Part I. A local study.

A study of 197 women referred for termination of pregnancy on psychiatric grounds was undertaken from February 1974 to May 1975 at a specially established clinic in the Department of Psychiatry, Groote Schuur Hospital, Cape Town. The personal, social and specifically psychiatric information collected from this study, which included both women who were refused and those granted termination on psychiatric grounds, was analysed. We gained enough data to focus on the psychosocial and 'hard' psychiatric data, to statistically compare the two groups, and to isolate variables which appeared to have influenced decision-making. Eighty per cent of the women were followed up for 12 - 18 months.

Abortion, Legal↗