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A letter to the editor is presented in response to the article about the reluctance of medical men to give evidence against colleagues by P. Harper in the April 1980 issue.

Objectives: 1) To describe activation skills of African American parents on behalf of their children with mental health needs. 2) To assess the association between parent activation skills and child mental health service use., Methods: Data obtained in 2010 and 2011 from African American parents in North Carolina raising a child with mental health needs (n = 325) were used to identify child mental health service use from a medical provider, counselor, therapist, or any of the above or if the child had ever been hospitalized. Logistic regression was used to model the association between parent activation and child mental health service use controlling for predisposing, enabling, and need characteristics of the family and child., Results: Mean parent activation was 65.5%. Over two-thirds (68%) of children had seen a medical provider, 45% had seen a therapist, and 36% had seen a counselor in the past year. A quarter (25%) had been hospitalized. A 10-unit increase in parent activation was associated with a 31% higher odds that a child had seen any outpatient provider for their mental health needs (odds ratio = 1.31, confidence interval = 1.03-1.67, p = 0.03). The association varied by type of provider. Parent activation was not associated with seeing a counselor or a therapist or with being hospitalized., Conclusion: African American families with activation skills are engaged and initiate child mental health service use. Findings provide a rationale for investing in the development and implementation of interventions that teach parent activation skills and facilitate their use by practices in order to help reduce disparities in child mental health service use., (Copyright © 2020 The Permanente Press. All rights reserved.)

A multi-centre general practitioner study was carried out in 2497 hypertensive patients. 81% of whom were already being treated for their condition, to assess the antihypertensive activity and tolerance of indapamide (2.5 mg/day in a single dose) when given in conjunction with or as replacement for existing therapy, if any. The results showed that, over a 3-month period, indapamide produced a gradual reduction in blood pressure (mean decrease of 24/14 mmHg) and there was a direct correlation between the initial diastolic pressure and the observed reduction. Side-effects with indapamide therapy were relatively few and mild, the most frequently reported being nausea, dizziness and headache. There were no consistent changes in any of the haematological or biochemical parameters monitored. An increase was noted in subjective well-being, measured by a visual analogue scale. Analysis of the results in 772 of the patients who were aged over 65 years showed that the response to and tolerance of indapamide was similar to that in younger patients.