Reviews

AIDS in Africa: The Social and Policy Impact edited by Norman Miller and Richard C. Rockwell Edwin Mellen Press, Lewiston (New York) and Queenston (Ontario), 1988. xxxi plus 336 pp. including map, tables, figures, notes, appendices and selected bibliographies. $110,00.

The Politics of Africa's Economic Stagnation by Richard Sandbrook Cambridge University Press, Cambridge, 1985. xiii plus 180 pp. including map, tables, notes and index. R.25,50 paperback.

Imperialism and Dependency: Obstacles to African Development by Daniel A. Offiong Howard University Press, Washington, DC, 1982. 304 pp. including tables, bibliography and index. $6,95 paperback.

Early Field Recordings: A Catalogue of Cylinder Collections at the Indiana University Archives of Traditional Music edited by Anthony Seeger and Louise S. Spear Indiana University Press, Bloomington, 1987. xviii plus 198 pp. $22,50.

Western Sahara: The Roots of a Desert War by Tony Hodges Lawrence Hill and Co., Westport (Connecticut), 1983. xii plus 388 pp. including maps, illustrations, tables, notes, appendix, bibliography and index. £6,95 paperback.

Somalia: Nation in Search of a State by David D. Laitin and Said S. Samatar Westview Press, Boulder (Colorado), and Gower, London, 1987. xvii plus 198 pp. including maps, illustrations, figures, tables, notes and index. $28,00.

Superpower Diplomacy in the Horn of Africa by Samuel M. Makinda Croom Helm, London and Sydney, 1987. 242 pp. including notes, appendices, select bibliography and index. £22,50.

Industrialization in West Africa by J.O.C. Onyemelukwe Croom Helm, London, 1984. v plus 226 pp. including tables, figures, bibliography and index. £17,95.

Modern Kongo Prophets: Religion in a Plural Society by Wyatt MacGaffey Indiana University Press, Bloomington, 1983. xiii plus 285 pp. including tables, figures, illustrations, notes, references and index. $12,00 paperback.

Naissance du Mozambique: Résistance et Révoltes Anticoloniales, 1854–1918 (Two Volumes) by René Pélissier Editions Pélissier, Orgeval (France), 1984. 833 pp. including maps, tables, notes, bibliography and index. $45,00 paperback.

The Political Economy of Namibia: An Annotated, Critical Bibliography by Tore LinnÉ Eriksen with Richard Moorsom Scandinavian Institute of African Studies, Uppsala, 1985. 423 pp. including map and authors’ index. SEK 110.

The Bureaucratic Struggle for Control of US Foreign Aid: Diplomacy versus Development in Southern Africa by Caleb Rossiter Bowker Publishing Co., Epping (England), and Westview Press, Boulder (Colorado), 1985. xiii plus 250 pp. including figures, tables, notes, bibliography and index. $25,50 paperback.

The Politics of Economic Power in Southern Africa by Ronald T. Libby Princeton University Press, Princeton (New Jersey), 1987. xxiii plus 361 pp. including maps, tables, bibliography and index. $45,00. $14,50 paperback.

South Africa in Crisis edited by Jesmond Blumenfeld Croom Helm, London, 1987. x plus 207 pp. including tables, notes and index. £19,95.

Pass Controls and the Urban African Proletariat in South Africa By Doug Hindson Ravan Press, Johannesburg, 1987. xii plus 121 pp. including notes, bibliography and index. R 14,00 paperback.

Hidden Struggles in Rural South Africa: Politics and Popular Movements in the Transkei and Eastern Cape, 1890–1930 by William Beinart and Colin Bundy Ravan Press, Johannesburg, 1987. xxvi plus 326 pp. including illustrations, maps, notes and index. R24,00 paperback.     

Plasma,oral fluid and sweat wipe ecstasy concentrations in controlled and real life conditions

In a double-blind placebo controlled study on psychomotor skills important for car driving (Study 1), a 75 mg dose of +/- 3,4-methylenedioxymethamphetamine (MDMA) was administered orally to 12 healthy volunteers who were known to be recreational MDMA-users. Toxicokinetic data were gathered by analysis of blood, urine, oral fluid and sweat wipes collected during the first 5h after administration. Resultant plasma concentrations varied from 21 to 295 ng/ml, with an average peak concentration of 178 ng/ml observed between 2 and 4h after administration. MDA concentrations never exceeded 20 ng/ml. Corresponding MDMA concentrations in oral fluid, as measured with a specific LC-MS/MS method (which required only 50 microl of oral fluid), generally exceeded those in plasma and peaked at an average concentration of 1215 ng/ml. A substantial intra- and inter-subject variability was observed with this matrix, and values ranged from 50 to 6982 ng/ml MDMA. Somewhat surprisingly, even 4-5h after ingestion, the MDMA levels in sweat only averaged 25 ng/wipe. In addition to this controlled study, data were collected from 19 MDMA-users who participated in a driving simulator study (Study 2), comparing sober non-drug conditions with MDMA-only and multiple drug use conditions. In this particular study, urine samples were used for general drug screening and oral fluid was collected as an alternative to blood sampling. Analysis of oral fluid samples by LC-MS/MS revealed an average MDMA/MDEA concentration of 1121 ng/ml in the MDMA-only condition, with large inter-subject variability. This was also the case in the multiple drug condition, where generally, significantly higher concentrations of MDMA, MDEA and/or amphetamine were detected in the oral fluid samples. Urine screening revealed the presence of combinations such as MDMA, MDEA, amph, cannabis, cocaine, LSD and psilocine in the multiple-drug condition.     

Worries and Health in Adolescence: A Latent Variable Approach

In this study, the most salient worries of Dutch adolescents are examined and the most often reported symptoms are ranked. The relationship between worrying and health is explored using structural modeling as are the frequently found gender differences in these areas. Worrying is postulated as an indicator of psychosocial well-being along with affectivity, ease of parental communications, tiredness, and loneliness. Health, or physiological status, is indicated by reported symptoms, frequency of doctors visits, aspirin consumption, and a global health measure. Four hundred and sixteen high-school students (211 girls and 205 boys) fitted in a questionnaire during school hours. The structure of the bet fitting model was the same for boys and girls, indicating that gender differences are a question of degree, and not of different structural relationships. Psychosocial well-being explained 77% of the variance in physiological status. The implications of the findings for health education are discussed.     

Acute selenium poisoning: suicide by ingestion

Selenium is a ubiquitous element in the environment essential to the human diet and widely utilized in industrial processes. Fatal human selenium intoxication is rare. The authors report a case in which investigators recovered a bottle of gun-bluing agent beside a 24-year-old man. He exhibited signs and symptoms typical of acute selenium intoxication presenting with nausea and vomiting, followed by pulmonary edema and rapid cardiovascular collapse approximately 3 to 4 h after ingestion. Classic electrocardiographic (EKG) changes, which have been reported to occur in acute selenium intoxication, included sinus tachycardia with ST wave alteration. Toxicological results confirmed elevated blood and tissue concentrations. The cause of death was ascribed to acute selenium intoxication, which ensued rapidly after oral consumption. The manner of death was suicide. This case report, which presents an overview of acute and chronic selenium poisoning, underscores the value of thorough toxicologic analyses of tissue and body fluids in humans.     

Medicare prospective payment: anticipated effect on hospitals, other community agencies, and families

The switch to prospective payment for hospitals under Medicare is expected to have ramifications in a number of different areas. This paper addresses a select number of those areas: hospital organization and management, other community agencies, and families. Questions are raised as to the capacity to provide adequate care in response to the increased demand for care outside the hospital setting that will result from the new payment system.