"It's Not Too Aggressive": Key Features of Social Branding Anti-Tobacco Interventions for High-Risk Young Adults.

Purpose. Peer crowd-targeted campaigns are a novel approach to engage high-risk young adults in tobacco use prevention and cessation. We elicited the perspectives of young adult key informants to understand how and why two social branding interventions were effective: (1) "COMMUNE," designed for "Hipsters" as a movement of artists and musicians against Big Tobacco, and (2) "HAVOC," designed for "Partiers" as an exclusive, smoke-free clubbing experience. Design. Qualitative study (27 semistructured qualitative phone interviews). Setting. Intervention events held in bars in multiple U.S. cities. Participants: Twenty-seven key informants involved in COMMUNE or HAVOC as organizers (e.g., musicians, event coordinators) or event attendees. Measures. We conducted semistructured, in-depth interviews. Participants described intervention events and features that worked or did not work well. Analysis. We used an inductive-deductive approach to thematically code interview transcripts, integrating concepts from intervention design literature and emergent themes. Results: Participants emphasized the importance of fun, interactive, social environments that encouraged a sense of belonging. Anti-tobacco messaging was subtle and nonjudgmental and resonated with their interests, values, and aesthetics. Young adults who represented the intervention were admired and influential among peers, and intervention promotional materials encouraged brand recognition and social status. Conclusion. Anti-tobacco interventions for high-risk young adults should encourage fun experiences; resonate with their interests, values, and aesthetics; and use subtle, nonjudgmental messaging

Public health officials and MECs for health should be held criminally liable for causing the death of cancer patients through their intentional or negligent conduct that results in oncology equipment not working in hospitals

Public health officials and Members of the Executive Council (MECs) for health who allow cancer patients to die because of a failure to renew service contracts for hospital oncology machines – without providing a viable alternative – may be found guilty of having the ‘eventual intention’ to cause such deaths, and convicted of murder if the other elements of the crime are satisfied. Should the National Prosecuting Authority (NPA) decline to prosecute them for murder, they may still be prosecuted for culpable homicide. To succeed in such a prosecution, the NPA would have to prove that reasonable public health officials in their position would have foreseen that a failure to renew service contracts for oncology machines at a hospital might deprive scores of cancer patients of early access to oncology services and result in their deaths

Art Experience, Art Enjoyment, and Fixed/Growth Mindset: Clues in the Case for Art Therapy

Existing research into the Creative Arts Therapies (or CAT), though still growing and not quite widely recognized across the field of Psychology, points toward the use of art related interventions to decrease stress levels and create a high sense of enjoyment, but little research has been done to examine the impact of particular components of said intervention. This includes how the role of the instructor of such an intervention would impact stress levels and enjoyment, if art experience of the participant has a role in the outcome of either variable, or if a particular mindset about creativity could impact one’s willingness to engage with the arts overall. The current study consisted of two studies, each exploring these possibilities as a means of broadening the acceptance of CAT. The first examined the impacts of both a high stress instruction type and a low stress instruction type of art intervention carried out on two randomized groups. Results showed that instruction type did not influence either group of participants, but instead found that stress levels decreased significantly, and that reported enjoyment was high across groups. Regardless of instruction type or art experience, a simple art intervention can have a positive impact on mental health and well-being. The second study collected data regarding participants’ opinions on and experience with the arts and compared with their mindset type regarding creativity: a fixed mindset or a growth mindset. Results found that those reporting a higher growth mindset type had more willingness to engage in the Creative Arts Therapies, along with higher enjoyment of the arts overall. This could indicate the need to work on increasing a growth mindset towards creativity and the arts to have more participants willing to engage in CAT. The findings of both studies call for more attention and validity to be given to the fields of CAT and for continued work at bringing art to more people both in the therapy setting and in their own free time

Human tissue and organ transplant provisions: Chapter 8 of the National Health Act and its Regulations, in effect from March 2012 – what doctors must know

Where provisions that were in the Human Tissue Act have been left out of the National Health Act they have been included in its regulations. However, new provisions in the latter Act provide strict controls for the transplantation of organs into non-South African citizens or non-permanent residents, and outlaw the charging of fees for human organs. The provisions also expand the list of persons who can give consent to donations from deceased persons to include ‘partners’, who now take precedence over all other relatives except spouses. Some of the matters in the Human Tissue Act that were not covered by the National Health Act have now been included in the regulations, such as: (i) the parties responsible for determining death of a person whose organs are to be removed for transplantation purposes; (ii) the requirement that tissue must be harvested within 24 hours from donated bodies; (iii) the removal of eye tissue; (iv) the exclusivity of rights in respect of tissue donations; and (v) confidentiality and publicity regarding tissue and organ transplants

Some consent and confidentiality issues regarding the application of the Choice on Termination of Pregnancy Act to girl-children

The Choice on Termination of Pregnancy Act (Choice Act) allows a female of any age to consent to a termination of pregnancy, but other statutes such as the previous Child Care Act and the present Children’s Act provide for different ages of consent for medical and surgical procedures. As a result doctors are not always certain whether girl-children are legally capable of giving informed consent for certain associated procedures when undergoing a termination of pregnancy. In addition the Criminal Law (Sexual Offences and Related Matters) Amendment Act (the Sexual Offences Act) imposes a duty to report sexual offences against children which may undermine the girl-patient’s right to confidentiality. This article attempts to clarify the legal position regarding these grey areas for practitioners faced with girl-child patients requesting terminations of pregnancy

Life Esidimeni deaths: Can the former MEC for health and public health officials escape liability for the deaths of the mental-health patients on the basis of obedience to ‘superior orders’ or because the officials under them were negligent?

Arising out of the reported evidence in the Life Esidimeni Arbitration hearings into the deaths of mental-health patients, the question arises as to whether the former member of the executive committee (MEC) for health, the mental health director, the head of the department of health and the project manager can use the defence of ‘superior orders’ to escape criminal or civil liability. Can the former MEC for health escape liability, by blaming the mental health director, the head of the department of health and the project manager for the deaths, as she did in her evidence? It is suggested that based on the reported evidence, neither the former MEC for health nor the mental health director, the head of the department of health nor the project manager can escape liability for negligently causing the deaths of the patients. They could all be prosecuted for culpable homicide, and in some instances – depending on the results of the arbitration hearings – be held liable to compensate surviving mentally ill patients for physical or psychological harm, and the families of deceased patients for psychological harm

Emergency medical treatment and ‘do not resuscitate’ orders: When can they be used?

The Constitution and the National Health Act provide that nobody shall be refused emergency medical treatment. ‘Do not resuscitate’ (DNR) orders require that certain patients should not be given cardiopulmonary resuscitation to save their lives. Whether there is a conflict between these two requirements is answered by considering: (i) the meaning of emergency medical treatment; (ii) the relationship between emergency medical treatment and DNR orders; (iii) the meaning of futile medical treatment; (iv) the relationship between DNR orders and euthanasia; and (v) when DNR orders may be lawfully used

Public health officials and MECs should be held liable for harm caused to patients through incompetence, indifference, maladministration or negligence regarding the availability of hospital equipment

There have been several reports of state hospitals not having functional equipment  such as radiological equipment. Where these are due to incompetence, indifference,  maladministration or negligence by the public officials concerned, they may be held  personally liable for the resulting harm to patients. However, the courts have often  observed that where the State has been sued vicariously for the wrongs of public  officials, it has not obtained reimbursement from the offending official. It has therefore  been suggested that irresponsible public servants should be sued in their personal  capacity (in addition to the State), to prevent taxpayers always having to pay for their  misdeeds. If an individual public official cannot afford to pay all the damages awarded, the injured party can recover the balance from the State by citing it as a vicarious joint wrongdoer

State doctors, freedom of conscience and termination of pregnancy revisited

There is a conflict in the South African Bill of Rights between the rights of women to reproductive health care and to make decisions about their reproductive capacity, and freedom of conscience on the part of the medical profession. State-employed doctors, unlike private practitioners, cannot pick and choose their patients. In emergency cases where there is a risk to the patient’s life or danger of grave illness, all doctors have a legal duty to render assistance to eliminate such risk or illness, and the same applies where the risk or danger arises from pregnancy. In non-emergency cases, doctors wishing to exercise freedom of conscience must refer patients to another doctor who is prepared to terminate the pregnancy – failure to do so may be construed as preventing or obstructing access to termination of pregnancy under the Choice on Termination of Pregnancy Act 92 of 1996

Terminating the pregnancy of a brain-dead mother: Does a fetus have a right to life? The law in South Africa

In the recent Texas case of Munoz v. John Peter Smith Hospital, the court granted a husband an order for the removal of life support from his brain-dead pregnant wife whose body was decaying, after a hospital had tried to keep her on ‘life support’ until the fetus was born. In South Africa the court would have issued a similar order but for different reasons, viz. because in this country: (i) a fetus has no legal rights until it is born; and (ii) unlawfully subjecting a dead pregnant women to ‘life-support’ measures to keep a fetus alive, where the deceased has not made a will to that effect, and against the wishes of the family, could result in a criminal charge of violating a corpse