Drug use and postgraduate students’ career prospects: Implications for career counselling intervention strategies

The study investigates the effect of drug use on postgraduate students’ career prospects by exploring associated risks of drug use and subsequent implications for career counselling intervention strategies within a university context. Students’ awareness of the psychosocial and health risks of drug use, knowledge and use of existing drug intervention services as well as behavioural impediments to their career prospects are assessed. An exploratory design within the qualitative approach was adopted involving in-depth interviews with professional informants and drug users within the postgraduate student cohort. Interpretive phenomenological analysis was applied for the synthesis and formulation of discursive themes. The article notes that denial and lack of coping strategies, improper personal conduct and unresponsive behaviour; poor academic performance and incriminating personal profiles were major potential impediments to postgraduate students’ career prospects. It was further noted that the current interventions’ continued use of scare tactics and information-based programmes needed to undergo a systematic evaluation. The article calls for more inclusive intervention strategies based on the life skills approach to address poor social coping strategies, mundane decision-making, low self-esteem and weak peer pressure resistance mechanisms to enhance students’ sober habits and competitiveness in the job market

Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes

Background There is a shortage of trained mental health workers in spite of the significant contribution of psychiatric disorders to the global disease burden. Task shifting, through the delegation of health care tasks to less specialised health workers such as community health workers (CHWs), is a promising approach to address the human resource shortage. CHWs in the Western Cape province of South Africa provide comprehensive chronic support which includes that for mental illness, but have thus far not received standardized mental health training. It is unknown whether a structured mental health training programme would be acceptable and feasible, and result improved knowledge, confidence and attitudes amongst CHWs. Methods We developed and piloted a mental health training programme for CHWs, in line with the UNESCO guidelines; the WHO Mental Health Gap Action Programme and the South African National framework for CHW training. In our quasi-experimental (before-after) cohort intervention study we measured outcomes at the start and end of training included: 1) Mental health knowledge, measured through the use of case vignettes and the Mental Health Knowledge Schedule; 2) confidence, measured with the Mental Health Nurse Clinical Confidence Scale; and 3) attitudes, measured with the Community Attitudes towards the Mentally Ill Scale. Knowledge measures were repeated 3 months later. Acceptability data were obtained from daily evaluation questionnaires and a training evaluation questionnaire, while feasibility was measured by participant attendance at training sessions. Results Fifty-eight CHWs received the training, with most (n = 56, 97.0%) attending at least 7 of the 8 sessions. Most participants (n = 29, 63.04%) demonstrated significant improvement in knowledge, which was sustained at 3-months. There was significant improvement in confidence, along with changes in attitude, indicating improved benevolence, reduced social restrictiveness, and increased tolerance to rehabilitation of the mentally ill in the community but there was no change in authoritarian attitudes. The training was acceptable and feasible. Conclusions Mental health training was successful in improving knowledge, confidence and attitudes amongst trained CHWs. The training was acceptable and feasible. Further controlled studies are required to evaluate the impact of such training on patient health outcomes. Trial registration PACTR PACTR201610001834198 , Registered 26 October 2016

An international multidisciplinary consensus statement on fasting before procedural sedation in adults and children

The multidisciplinary International Committee for the Advancement of Procedural Sedation presents the first fasting and aspiration prevention recommendations specific to procedural sedation, based on an extensive review of the literature. These were developed using Delphi methodology and assessment of the robustness of the available evidence. The literature evidence is clear that fasting, as currently practiced, often substantially exceeds recommended time thresholds and has known adverse consequences, for example, irritability, dehydration and hypoglycaemia. Fasting does not guarantee an empty stomach, and there is no observed association between aspiration and compliance with common fasting guidelines. The probability of clinically important aspiration during procedural sedation is negligible. In the post-1984 literature there are no published reports of aspiration-associated mortality in children, no reports of death in healthy adults (ASA physical status 1 or 2) and just nine reported deaths in adults of ASA physical status 3 or above. Current concerns about aspiration are out of proportion to the actual risk. Given the lower observed frequency of aspiration and mortality than during general anaesthesia, and the theoretical basis for assuming a lesser risk, fasting strategies in procedural sedation can reasonably be less restrictive. We present a consensus-derived algorithm in which each patient is first risk-stratified during their pre-sedation assessment, using evidence-based factors relating to patient characteristics, comorbidities, the nature of the procedure and the nature of the anticipated sedation technique. Graded fasting precautions for liquids and solids are then recommended for elective procedures based upon this categorisation of negligible, mild or moderate aspiration risk. This consensus statement can serve as a resource to practitioners and policymakers who perform and oversee procedural sedation in patients of all ages, worldwide

Anaesthesia in connective tissue disorders

The original publication is available at http://www.samj.org.zaPatients with the more common connective tissue disorders require surgical operations more frequently than has been realized. They may present the anaesthetist with many potential problems. A few minutes of careful questioning and examination pre-operatively may prevent a tragic situation. A history of drug therapy is essential pre-operative information, particularly since many of these patients will need augmentation or coverage with steroid drugs. The anaesthetist must be aware of the patient's general state of health and must search for evidence of pulmonary, cardiac or haematological abnormalities.Publishers' versio

Overview of pharmacological aspects of sedation--Part I.

[No abstract available]Revie

Conscious sedation.

[No abstract available]Articl

Anaesthesia for thymectomy in myasthenia gravis

The original publication is available at http://www.samj.org.zaAANHALING: Roelofse, J.A. 1981. Narkose vir timektonie in myasthenia gravis. S Afr Med Tyd, 60(10):619-620.ENGLISH ABSTRACT: This report emphasizes the medical, surgical and anaesthetic aspects of the treatment in cases of myasthenia gravis. Since many of the drugs used in anaesthesia affect the activity of the neuromuscular conduction mechanism, the anaesthetist should be aware of the pathophysiology of the disease and of the effect which these drugs have on it.Publisher’s versio

Overview of pharmacological aspects of sedation. Part 2. Combination sedative/analgesics.

[No abstract available]Articl