The end of an era

No Abstract.South African Psychiatry Review Vol. 10 (2) 2007: pp.53-5

Training psychiatrists in South Africa

No Abstract

Patient access to care- a need for mental health leadership, and a role for industry

No Abstract

South African Psychiatry - charting a way forward

Editorial - No Abstrac

Meanings of thinness and dysfunctional eating in black South African females: A qualitative study

Objective: This study qualitatively explored local meanings of thinness and dysfunctional eating in black adolescent females inthe rapidly westernizing socio-cultural context of post-apartheid South Africa. Method: Four (n=4) urban state highschools in KwaZulu-Natal were selected from which 40 subjects were sampled from Grades 9-12. Focus groups were conducted following a semi-structured interview and analysed using Constant Comparative Analysis. Results: Subjects reported a wide range of different meanings for thinness, which included traditional idioms of distress and typically western pressures towards thinness, which was particularly evident in the multicultural schools. Subjects also reported a wide range of dysfunctional eating practices (such as purging) which were underscored by a wide range of motivations, including traditional practices and western body image concern; and which did not tend to follow patterns of 'dieting' that are typical in affluent, western societies.Conclusion: Western pressures towards thinness may be blending with traditional idioms of distress and culturally sanctioned rituals of remedial purging and social over-eating, thereby placing this group at particular risk for a range of dysfunctional eating patterns that may not follow typically western paradigms or diagnostic systems.Keywords: Meanings of thinness; Eating disorders; Non-western, South Afric

Surgeons and HIV: South African Attitudes

Objectives. The HIV status of surgeons, in the context of the informed consent obtained from their patients, is a contentious matter. We surveyed the views of practising surgeons in South Africa regarding aspects of HIV and its impact on surgeons. Design. A cross-sectional survey of surgeons who were members of the Association of Surgeons of South Africa, regarding their attitudes to the preceding issues. Results. The salient findings included the view that a patientcentred approach requiring HIV status disclosure to patients would be discriminatory to surgeons and provide no clear benefit to patients, and that HIV-positive surgeons should determine their own scope of practice. Conclusion. Patient-centred approaches and restrictive policies, related to this issue, do not accord with clinician sentiment. In the absence of comparable local or international data, this study provides clinicians\' views with implications for the development of locally relevant policies and guidelines South African Medical Journal Vol. 99 (2) 2009: pp. 110-11

Experience and views of academic psychiatrists on the role of spirituality in South African specialist psychiatry

CONTEXTO: A importância de ter de considerar o papel da espiritualidade na saúde, saúde mental e psiquiatria na África do Sul tem sido especialmente enfatizada pela recente legislação sobre práticas tradicionais de saúde na África. OBJETIVO: Explorar as opiniões e experiências de psiquiatras locais sobre o papel da espiritualidade na prática e no treinamento de especialistas em psiquiatria na África do Sul. MÉTODO: Este estudo é uma pesquisa qualitativa, exploratória, descritiva, contextual, fenomenológica e geradora de hipótese. A fonte principal de dados foram entrevistas semiestruturadas com psiquiatras filiados a uma universidade local. Para assegurar de que os dados fossem confiáveis, as seguintes medidas foram incluídas: credibilidade, transferibilidade, confiabilidade, e confirmabilidade. RESULTADOS: A consciência da espiritualidade, "mindfulness", e uma abordagem de mente aberta sobre a espiritualidade, segundo os participantes, devem ser facilitadas na prática e no treinamento psiquiátrico. Seis temas foram identificados por meio de códigos abertos. DISCUSSÃO: Todos os participantes, independentemente de suas próprias visões sobre espiritualidade e religião, concordaram que, sob certas condições, a espiritualidade deve ser incorporada na abordagem biopsicossocial atual na prática local e no treinamento de especialistas em psiquiatria.BACKGROUND: The importance of having to consider the role of spirituality in health, mental health and psychiatry in South Africa has in particular been emphasized by recent legislation on African traditional health practice. OBJECTIVE: The purpose of this study was to explore the views and experience of local psychiatrists regarding the role of spirituality in South African specialist psychiatric practice and training. METHOD: This study is an explorative, descriptive, contextual, phenomenological and theory-generating, qualitative investigation. In-depth, semi-structured interviews with individual academic psychiatrists affiliated to a local university were conducted as primary data source. Measures to ensure trustworthiness included credibility, transferability, dependability and confirmability. RESULTS: Awareness of spirituality, "mindfulness" and an open-minded approach about spirituality should, according to participants, be facilitated in psychiatric practice and training. Six themes were identified through open coding. DISCUSSION: All participants, disregarding of their own views on spirituality and religion, agreed, that under certain conditions, spirituality must be incorporated into the current bio-psycho-social approach in the local practice and training of specialist in psychiatry

The role of spirituality in specialist psychiatry: A review of the medical literature

A review of the international medical literature was undertaken on the role of spirituality in the discipline of psychiatry, within the context that a perceived change is taking place in the health care environment in South Africa. Revitalized interest in spirituality was evident from the literature partly because Western societies have, through the migration of people, become more heterogeneous in recent years. The literature concurred that spirituality must be incorporated into the current approach to the practice and training of psychiatry, but within the professional scope of the discipline, while all faith traditions and belief systems should be regarded equally. Beyond South Africa, it is envisaged that the review has implications for the practice of psychiatry in Africa.Keywords: Spirituality; Practice and training; Psychiatry; Medical literature; Qualitative inquir

Conditioned stochastic particle systems and integrable quantum spin systems

We consider from a microscopic perspective large deviation properties of several stochastic interacting particle systems, using their mapping to integrable quantum spin systems. A brief review of recent work is given and several new results are presented: (i) For the general disordered symmectric exclusion process (SEP) on some finite lattice conditioned on no jumps into some absorbing sublattice and with initial Bernoulli product measure with density $\rho$ we prove that the probability $S_\rho(t)$ of no absorption event up to microscopic time $t$ can be expressed in terms of the generating function for the particle number of a SEP with particle injection and empty initial lattice. Specifically, for the symmetric simple exclusion process on $\mathbb Z$ conditioned on no jumps into the origin we obtain the explicit first and second order expansion in $\rho$ of $S_\rho(t)$ and also to first order in $\rho$ the optimal microscopic density profile under this conditioning. For the disordered ASEP on the finite torus conditioned on a very large current we show that the effective dynamics that optimally realizes this rare event does not depend on the disorder, except for the time scale. For annihilating and coalescing random walkers we obtain the generating function of the number of annihilated particles up to time $t$, which turns out to exhibit some universal features.Comment: 25 page