South Africa: the new world of disability.

Over the past 10 years, unique business imperatives in South Africa have led to innovative risk product design, some of which are still unfamiliar to the rest of the world. The main drivers are: the unique mix of first- and third-world societies in our country, and an energetic marketing force operating in an already highly saturated insurance market. As a result, new product design has become one of the most effective ways to grow new business volumes in this competitive environment.

Assessing impairment and disability for syndromes presenting with chronic fatigue.

Many disability claims are based on the subjective symptom of fatigue, which can be caused by a wide spectrum of diagnoses including fibromyalgia, chronic fatigue syndrome and cardiopulmonary diseases. Chronic pain is very often a compounding problem. It is vital for every insurer to have fair and objective criteria to distinguish between invalid claims and those with merit.

Medical problem-solving: a five stage approach in primary medical care.

A methodology for a five stage or pentagonal problem-based approach to solve individual or family health-related problems is described. The model can be applied in health worker learning, student teaching or problem solving in the real world of the patient and his/ her family within the context of community health. The model stresses interdisciplinary co-operation, the consideration of ethical factors in each case, and a logical transition from individual patient care to community diagnosis and intervention.

Nuclear-encoded subunits of human cytochrome c oxidase: SstI restriction fragment length polymorphism.

A DNA polymorphism of the nuclear-encoded subunit Va of the human cytochrome c oxidase (COX), a mitochondrial respiratory enzyme, is reported. No polymorphism was detected in genes for the subunits IV and Vb of the same enzyme.

Superior fatigue resistance of elite black South African distance runners.

Black athletes currently dominate long-distance running events in South Africa. In an attempt to explain an apparently superior running ability of black South African athletes at distances > 3 km, we compared physiological measurements in the fastest 9 white and 11 black South African middle-to long-distance runners. Whereas both groups ran at a similar percentage of maximal O2 uptake (%VO2max) over 1.

Diarrhoeal disease--epidemiology and intervention.

The causes of the complex triad of gastro-enteritis, other related infections and malnutrition have at their roots poverty, lack of political will, overpopulation and destruction of the environment. Intervention involves multiple sectors of the economy and not only the health services of a country, and should take place as early as possible during the natural history of the disease.

Corneal disease in rural Transkei.

A survey of external eye diseases was undertaken in Transkei; a total of 1,519 people were examined. A high incidence of climatic droplet keratopathy was found in the population, and this was a common cause of blindness in elderly men. Only 7 people had pterygia - all women.

Rubella--a case for immunising male adolescents.

An outbreak of rubella at a training institution for predominantly adolescent males is described. The cost and inconvenience of the outbreak furnish evidence that immunisation in its own right is worth while, and should not be seen only as a means of protecting susceptible females of child-bearing age.

The epidemiology of snakebite in northern Natal.

The epidemiology of snakebite in 164 patients treated at Ngwelezana Hospital, Empangeni, Natal, is described. The person mostly at risk is the young Black adult female busy with her traditional chores at around sunset. She usually gets bitten on her bare foot by an unidentified species of snake, resulting in mild cytotoxic evenomation.