"The tongue is venomous": perception, verbalisation and manipulation of mortality and fertility regimes in rural Mali.

Demographic theory frequently assumes that pre-transitional populations adopt fatalistic attitudes to fertility and mortality. Fertility decline is said to require a "pro-active" mentality incorporating a newly conceived idea of numeracy about children and a new-found awareness by individuals of where they stand in relation to demographic norms. Nonnumeric responses to questions about desired family size are interpreted as meaning that women are unable to conceptualise their ideal number of children and are unaware of their demographic environment. However, ethnographic evidence from the Malian Fulani will show how women accurately appraise their mortality and fertility regimes and how they actively seek to manipulate them via a series of ritual behaviours. It is described how women do think numerically about demographic outcomes but are reluctant to verbalise this numeracy as it is believed that it will incur supernatural risks. The implications for demographic research of the widespread belief in the danger of verbalising numbers of children are discussed

Management of treatment resistant schizophrenia

Whilst gains have been made in recent years in the pharmacological treatment of schizophrenia, a number of patients still have residual symptoms and disabilities, or simply do not show response to antipsychotic medications. For such 'treatment resistant' patients, there is little by way of randomised controlled data to support any particular type of further intervention, but combinations of agents (combined antipsychotics, augmentation with mood stabilisers, antidepressants, and other agents)can show benefit in certain patients in certain domains of symptomatology and psychosocial functioning. Certain psychological and psychosocial treatment strategies can also be of benefit in this regard. This article selectively reviews the literature treatment resistance in schizophrenia, and emphasises the importance of an holistic approach to individual patients. Keywords: schizophrenia, treatment resistance, antipsychotics, augmentation, psychosocial treatments South African Psychiatry Review Vol. 9(1) 2006: 17-2