Cranbrook, Kent, and its neighbourhood area, c. 1570-1670

This thesis contributes to the discipline of historical research through the detailed local study and analysis of micro-economic developments and social trends within the 'market town' of Cranbrook, Kent and its neighbouring parishes. In particular this study examines the symbiotic relationship between the market town as a nodal point for industry and commerce within the context of the local economy and social structure of its rural hinterland. The nature and incidence of demographic growth within Cranbrook's neighbourhood during local periods of epidemic disease and economic dislocation, provide a context in which to examine the extent to which the Wealden wood pasture agrarian regime could absorb and sustain demographic growth within individual local economies. Social relations within Cranbrook, show that the town was not isolated from its rural hinterland. The inhabitants of the town and the countryside interacted within a local economy based upon textile manufacture and farming, which effectively defined the complex social hierarchy of the 'neighbourhood'. Kinship-networks among longstanding resident families and their comparative status, wealth and influence within individual parishes, show the importance of familial relationships to business success and social status within the community. Parish office holding among Cranbrook's 'chief inhabitants' are explored within the concepts of religious ideology and social control in early modem England. Cranbrook society is examined within the context of developing religious attitudes and puritan ideas, which took hold and flourished in this period. The thesis also investigates the slow decline of the broadcloth industry in the region and contributes to the proto-industrialization debate. The effect of economic recession in broadcloth manufacture is examined against the decline of the neighbourhood population, the contraction in market demand for Wealden broadcloth and increased poverty

Studies in behavioural epidemiology

Collection of papers submitted to the Faculty of Medicine, University of Cape Town, in fulfilment of the requirements of Part III of the Degree Master of Medicine in Psychiatry.The following five papers are included in this collection. Paper 1. Flisher AJ, Joubert G, Yach D. Mortality from external causes in South African adolescents, 1984 - 1986. South African Medical Journal 1992; 81: 77-80. Paper 2. Flisher AJ, Chalton DO. High school dropouts in a working-class South African community: selected characteristics and risk-taking behaviour. Journal of Adolescence (in press). Paper 3. Flisher AJ, Roberts MM, Blignaut RJ. Youth attending Cape Peninsula day hospitals. Sexual behaviour and missed opportunities for contraception counselling. South African Medical Journal 1992; 82: 104-106. Paper 4. Flisher AJ, Parry CDH. Suicide in South Africa. An analysis of nationally registered mortality data for 1984-1986. Acta Psychiatrica Scandinavica (in press). Paper 5. Flisher AJ, Parry CDH, Bradshaw D, Juritz J. Suicide in South Africa - seasonal variation. Acta Psychiatrica Scandinavica (to be submitted)

Selected results of the "methods for the epidemiology of child and adolescent mental disorders" study

Bibliography: leaves 68-75

Prevalence of substance use among rural high school students in Limpopo Province, South Africa

This study documents the prevalence rates for use of cigarette, alcohol, methylated spirit, cannabis, mandrax and cannabis together, glue or thinners among rural high school students in Mankweng, Limpopo Province, South Africa. A multistage sampling procedure produced a sample of 1600 students in grades 9 and 11 who completed a self-administered questionnaire. The prevalence rates for previous mouth (recent) use of alcohol, cigarettes, cannabis glue and spirits were 6.4%, 10.5%, 1.4%, 1.2% and 0,8% respectively. For all substances, males had higher prevalence rates than females. Developing alcohol and drug programme for high school students that are more gender specific may improve the effectiveness of intervention efforts at high schools. KEY WORDS: substance use, rural high school students, South Afric

Standards for the mental health care of people with severe psychiatric disorders in South Africa: Part 2. Methodology and results

Objective: Mental health care standards have been developed to describe what is an acceptable and adequate quality of mental health care for service users in South Africa. Part two describes the standards development methods, the range of standards developed and, as an example, the rights and protection standards domain. Methods: a systematic literature review and broad consultation to develop a set of normative- based standards. Consultation included widespread draft document distribution/feedback, in-depth provinical workshops, and focus groups. Structually, detailed criteria and sub-criteria were developed for measurability and adequate detail in key service areas. Results: Three types of standards were developed: core standards, standards for service delivery and for specific settings. Standards to ensure the rights and protection of varied service users within a range of contexts are described. Conclusion: A standards document is an essential component of a quality improvement process, within the context of a supportive legislative, political and managerial framework.Keywords: standards, mental health care, South Africa, methodology, results South African Psychiatry Review Vol. 8(4) 2005: 146-15

Conducting Epidemiological Research in South Africa: Challenges in the Data Collection Process

This article addresses the challenges faced by research supervisors and research assistants while collecting data to explore the prevalence of psychiatric disorders among children and adolescents in South Africa. The article focuses on budgetary constraints, interviewee expectations, moral issues, limited confidentiality, fatigue factors and racial issues that threatened the completion of the project. These challenges are examined from the emic-etic theoretical paradigm and the interactions between the research supervisors, the research assistants and the research participants are analyzed. The authors propose recommendations that can serve to prepare researchers who embark on conducting research in similar socio-cultural environments

Needs and services at an in-patient psychotherapy unit

Objective: To describe the impact of services provided, during an admission, on unmet needs and correlates of unmet needs. Method: The study used a modified version of The Camberwell Assessment of Need (CAN) to assess the perceived needs of 100 patients on admission to a psychotherapy unit, Valkenberg Hospital, Cape Town. At discharge, the study documented the extent to which the patients had perceived services and interventions to be useful. Results: The mean number of needs on admission was 8.6. At discharge, help received was highest for psychiatric needs. The services most often regarded as useful were organised group activities and therapies. Regression analysis suggests that a lower level of education and the presence of borderline personality traits contribute significantly to unmet need on discharge. Conclusion: The in-patient program is effective in meeting psychiatric needs, but less useful for addressing psycho-social needs. These needs may exacerbate psychiatric problems and should be managed more actively before, during and after an in-patient sta

Standards for the mental health care of people with severe psychiatric disorders in South Africa: Part 1. Conceptual issues

Part one describes conceptual issues underlying the development of South African standards for people with severe psychiatric disorders. Mental health care standards seek to describe what is an acceptable and adequate quality of mental health care for service users. A focus on service quality is especially crucial in resource constraint contexts. Standards are essential tools for quality assurance, advocacy and rights protection, capacity and management development and dialogue. They should be appropriate, useful and patient-centred, and operationalise local policy and legislation. Mental health standards are a challenge to define, and need to combine both a consumer and rights based approach. International and local standards and views were adapted and included in order to develop these standards which should be applicable, measurable and gradable across all South African contexts. Keywords: standards, mental health care, South Africa, conceptual South African Psychiatry Review Vol. 8(4) 2005: 140-14