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Numerous follow-up studies have shown that patients with mood disorders who do not receive prophylactic medication are at increased risk of death, particularly from suicide. After 11 years follow-up we compared the mortality of 103 patients attending a lithium clinic with that expected on the basis of age/sex/year-specific rates for England and Wales. Only 10 patients died during the study, although the expected number of deaths was 18.31 ( P = 0.052, two-tailed) and no deaths from suicide were observed. After correcting for the prevalence of mood disorder in the general population, the relative risk was 0.60 (95% CI 0.29-1.12) which suggests that lithium reverses the excess mortality associated with recurrent mood disorders, including that from suicide.

This paper examines the macroeconomic impact of labour based road construction in rural, underdeveloped areas. The macroeconomic effect is measured by the contribution to gross domestic product (GDP), number of indirect jobs created nationally, contribution to taxes and contribution to indirect household income for each of eleven rural road construction projects. The paper has two objectives. The first is to determine the overall multiplied impact of road construction in rural underdeveloped areas in South Africa. The second is to determine the macroeconomic impact of marginal changes in the use of labour and plant in road construction. Input-output analysis was used to analyse a total of eleven projects. It was found that the GDP multiplier ranged between 1, 34 and 1, 53 with an average of 1, 45. The cost of creating an indirect job ranged from R95 250 to R145 972 with an average cost of R113 835. The effect of substituting labour for plant in the construction methods is examined by means of sensitivity analysis. The sensitivity analysis shows that as the proportion of labour increases relative to plant so the macroeconomic benefits increase and therefore by implication poverty alleviation.

Towards the end of 2000, a study was commissioned into the projected economic impact of the new Cape Town International Convention Centre. The study set out to measure the macroeconomic impact of the Convention Centre as well as identify industries that could be promoted by the existence of the Centre.

The aim of this working paper is to investigate the optimal regulatory routes from a competition and public interest point of view for the South African water industry. The working paper presents the basic conditions of the water sector by outlining the main characteristics of water, providing an historical and international overview of water management in South Africa.

The relationship between neurotransmitter metabolite concentrations and measurements of ventricular size on CAT scans and pneumoencephalographs was investigated in 15 patients with severe affective disorder. An association was identified between reduced levels of plasma free tryptophan and ventricular enlargement and also between raised ventricular CSF levels of 5 HIAA and ventricular enlargement.

The relationship between unemployment and parasuicide was examined amongst males and females in the City of Leeds between 1978 and 1982. The association between unemployment and parasuicide was found to be positive and significant in middle aged men. However, there was a negative and significant relationship between unemployment and parasuicide in older men aged between 55 and 59 years. For females between the ages of 20 and 25 years there was a significant negative relation ship between unemployment and parasuicide. The findings which are discussed are considered to provide evidence for the hypothesis that unemployment may exert a differing vulnerability effect on proneness to parasuicide in different age groups and between the two sexes.

General Ligand Affinity Chromatography: N6-(6-Aminohexyl) 3',5'-ADP Sepharose as an Affinity Adsorbent for the CoA-Dependent Enzyme, Succinate Thiokinase

A randomized double blind group comparison study of sulpiride and amitriptyline was carried out in 36 patients suffering from major depressive disorder (DSM III critieria). Sulpiride showed equivalent antidepressant activity to amitriptyline at 4, 6 and 12 weeks, using the Hamilton Rating Scale (HRS) and the Wakefield Self-Rating Scale for depression (WRS). However, at 24 weeks the antidepressant activity of amitriptyline was just statistically significantly better than that of sulpiride. Timing of onset of action was comparable in both drugs. The anxiolytic activity of sulpiride was equivalent to that of amitriptyline at 4, 6, 12 and 24 weeks using the Salkind Manifest Anxiety Inventory as a measure. There were no significant differences between the two groups, of variables measured by the Crown-Crisp Experiential Index, a life events scale and Paykel's Social Adjustment Scale.

SummaryThe pneumo-encephalographs and computerized axial tomography scans of fifty patients with severe affective disorder were studied. Measures of ventricular size were compared with those reported by other workers. Findings suggested that some patients suffering from severe affective illness showed abnormalities of brain structure as demonstrated by ventricular enlargement.

A special clinic was set up in an attempt to overcome the problem of accumulating a sufficient number of depressed patients for inclusion in clinical trials. Only 21 patients of the 81 patients referred during 1 year fulfilled the criteria for inclusion in the trials. The function of the special clinic did not prove successful as a similar proportion of depressed patients was found in a comparison group referred to the district psychiatric outpatient clinic.

Publisher Summary This β -galactosidase system has played an important role in the development of the view that immobilized ligands with dissociation constants in the millimolar range are capable of promoting very strong specific adsorption, and this view in turn has led to the development of the concept of “progressively perpetuating effectiveness.” This concept is not consistent with much other evidence, or with the theoretical treatment summarized in the next section, and it is difficult to reconcile with kinetic theory in general. Again, the observations that largely gave rise to this concept are explainable in terms of nonbiospecific rather than biospecific adsorption.

The synthesis of a new coenzyme A analogue, N6-[N-(6-aminohexyl)carbamoylmethyl]-CoA, suitable for immobilisation through its terminal amino group to support matrices, is described. The synthetic route starts with bis(CoA) and involves the following steps: alkylation with iodoacetic acid and rearrangement yielding bis(N6-carboxymethyl-CoA), elongation of the carboxymethyl terminal with 1,6-diaminohexane using carbodiimide to yield bis(N6-[N-(6-aminohexyl)-carbamoylmethyl]-CoA) and finally the splitting of this bis[CoA analogue) through reduction with dithiothreitol to give the final product in approximately 10% overall yield. This CoA analogue showed 'coenzymic activity' with the enzymes acetyl-CoA synthetase, phosphotransacetylase and succinic thiokinase. Covalent binding of the CoA analogue to Sepharose 4B was normally carried out using its S-(5-thio-2-nitrobenzoic acid) derivative as this allows a convenient way for determining the amount of ligand coupled, based on the amount of 5-thio-2-nitrobenzoic acid liberated from the gel after reduction with dithiothreitol. After covalent binding of the CoA analogue to water-soluble activated dextran 70, the analogue was recycled while present in an ultrafiltration cell using the enzymes phosphotransacetylase and citrate synthase. The reaction was followed by measuring the citrate formed on addition of acetylphosphate and oxaloacetate. In affinity chromatographic studies it was shown that the CoA-Sepharose preparation could bind the CoA-dependent enzymes citrate synthase and succinic thiokinase and these could be biospecifically eluted using soluble CoA.

1. Three established methods for immobilization of ligands through primary amino groups promoted little or no attachment of NAD+through the 6-amino group of the adenine residue. Two of these methods (coupling to CNBr-activated agarose and to carbodi-imide-activated carboxylated agarose derivatives) resulted instead in attachment predominantly through the ribosyl residues. Other immobilized derivatives were prepared by azolinkage of NAD+(probably through the 8 position of the adenine residue) to a number of different spacer-arm–agarose derivatives. 2. The effectiveness of these derivatives in the affinity chromatography of a variety of NAD-linked dehydrogenases was investigated, applying rigorous criteria to distinguish general or non-specific adsorption effects from truly NAD-specific affinity (bio-affinity). The ribosyl-attached NAD+derivatives displayed negligible bio-affinity for any of the NAD-linked dehydrogenases tested. The most effective azo-linked derivative displayed strong bio-affinity for glycer-aldehyde 3-phosphate dehydrogenase, weaker bio-affinity for lactate dehydrogenase and none at all for malate dehydrogenase, although these three enzymes have very similar affinities for soluble NAD+. Alcohol dehydrogenase and xanthine dehydrogenase were subject to such strong non-specific interactions with the hydrocarbon spacer-arm assembly that any specific affinity was completely eclipsed. 3. It is concluded that, in practice, the general effectiveness of a general ligand may be considerably distorted and attenuated by the nature of the immobilization linkage. However, this attenuation can result in an increase in specific effectiveness, allowing dehydrogenases to be separated from one another in a manner unlikely to be feasible if the general effectiveness of the ligand remained intact. 4. The bio-affinity of the various derivatives for lactate dehydrogenase is correlated with the known structure of the NAD+-binding site of this enzyme. Problems associated with the use of immobilized derivatives for enzyme binding and mechanistic studies are briefly discussed.

The relationship of concurrent benzodiazepine administration to seizure duration in ECT was examined. Administration of a standard oral dose of 10 mg diazepam to a series of patients suffering from major depressive disorder produced a significant reduction in men seizure length during ECT compared to length of ECT-induced seizure in those patients when they were benzodiazepine free. This finding is discussed.

Publisher Summary In the search for an effective immobilized ligand, attention was concentrated on analogs of pyruvate rather than of lactate, because kinetic studies indicate that pyruvate has considerably higher affinity for the enzyme. As explained in this chapter, the kinetic mechanism of the enzyme requires the addition of NADH to the irrigating buffer during affinity chromatography. Under these conditions catalytically susceptible immobilized analogs (e.g., β-mercaptopyruvate, attached through the β-thiol group) underwent enzymatic reduction when the enzyme was applied, and such analogs proved to be unsatisfactory for affinity chromatography. Oxamate is a structural analog of pyruvate that is not catalytically susceptible, but retains the binding characteristics of pyruvate for lactate dehydrogenase. This analog, immobilized through the amide grouping proved to be a very effective affinity chromatographic ligand. The amide nitrogen group corresponds to the methyl group of pyruvate and was chosen as the point of attachment because available specificity studies indicated that pyruvate analogs in which the methyl group is substituted remain effective as substrates for lactate dehydrogenase.

To assess the possible significance of cerebral ventricular size and the dexamethasone suppression test (DST) in the outcome of severe endogenous depression, 28 patients were followed up and reviewed 1 year after stereotactic subcaudate tractotomy. Neither ventricular size nor the dexamethasone suppression test predicted either a good or poor outcome. There was no relationship between ventricular size and the DST results.

Agriculture is the single most important sector in Malawi due to its contribution to the economy ranging from employment creation, contribution to GDP growth to source of foreign exchange earnings. These significant contributions have necessitated the Government of Malawi to develop strategies and policies such as the Farm Input Subsidy Programme (FISP), whose main aim is to increase household incomes and reduce food insecurity and ultimately reduce poverty. It is nine years since the introduction of FISP but its results remain mixed. Using the 2009/10 Integrated Household Survey Phase 3 (IHS3) dataset, a logistic regression in a multivariate data analysis approach was used to investigate the impact of FISP on income levels and food security of rural smallholder farmers in Malawi. The analysis showed that about 82 percent of smallholder farmers live in rural areas, about 75 percent of them were males, 71 percent were married, 70 percent did not go to school and 69 percent benefited from FISP. In farming, 68 percent of these smallholder farmers had less than 1 hectare of farms, 70 percent of them had labour force of less than 5 people, 51 percent of them harvest less than 5 bags of 50kgs of maize of which 92 percent sell most of their harvested maize and 89 percent of them receive less than MK5, 000 from sales. In addition, about 99 percent of these smallholder farmers were food insecure as they save less than 1 bag of 50kgs after harvest. Only 1 percent of these smallholder farmers receive remittances and 21 percent had other income generating activities (IGAs). Demographic and socio-economic factors have no impact on these farmers capability to increase income levels and enhance their food security. There is also no statistically significant difference between FISP beneficiaries and non-beneficiaries in terms of capabilities of increasing incomes and enhancing food security. It is, therefore, concluded that FISP had no significant impact on the abilities of these smallholder farmers to increase their incomes and enhancing their food security. Hence, FISP did not prove to be the best food security and poverty alleviation tool in Malawi.

Microfinance targets the poor and very poor, both in urban and rural areas. It has become a common method of poverty alleviation in many developing countries. Several microfinance institutions have adopted a social mission to eradicate poverty by providing credit to the poor. In the past, microfinance organizations used to focus on farmers in rural areas. Modern microfinance programs are focused on the population that is largely neglected by the formal financial sector, specifically women. Due to the perceived risk in this type of uncollateralized lending, private equity markets are not keen on financing microfinance institutions. Furthermore, microfinance institutions are seen as socially motivated as opposed to being financially motivated. For that reason, their profitability and sustainability has come under question in the last decade. Two approaches to the issue of sustainability exist. The dominant institutionist approach argues that microfinance institutions should focus on being sustainable as this will improve their chances of alleviating poverty. The welfarist approach disagrees with this view by arguing that focusing on sustainability will result in the neglect of the poorest of the poor. This study analyses the sustainability of microfinance in South Africa by using a case study research approach. The study explores the challenges to sustainability in South Africa. The results of the study indicate that the microfinance institutions are not profitable nor self- sufficient. The most notable challenge to this sustainability is the high personnel costs. South African MFIs experience higher operating costs than their African counterparts. The study also indicates that the more financially sound microfinance institutions have a lower level of depth outreach than the more subsidy dependent institutions.

Bibliography: pages 84-86., Zimbabwe officially abandoned financial repression when it introduced financial liberalisation in 1991. Since independence in 1980, the government had used interest rate controls and strict foreign exchange regulations in order to control the economy. This mini-dissertation will analyse financial reforms in Zimbabwe from 1991 to 1997. The analysis will consider whether there were statistical grounds to believe that the financial liberalisation hypothesis would work. That is, do real interest rates in Zimbabwe have a statistically significant and positive relationship with real money demand and real savings? This paper will show that in Zimbabwe this relationship does indeed exist. The existence of such a relationship suggests that the freeing of interest rates in 1991 should have raised savings and financial intermediation as the theory predicts. However, as this did not happen, this paper will put forward reasons why, from 1991 to 1997, lifting controls in the economy did not increase savings as expected.