Does religious identification of South African psychiatrists matter in their approach to religious matters in clinical practice?

BACKGROUND. It is not known whether psychiatrists’ approach to religious matters in clinical practice reflects their own identification or non-identification with religion or their being active in religious activities. OBJECTIVE. This question was investigated among South African (SA) psychiatrists and psychiatry registrars, including the importance they attach to the religious beliefs of patients for diagnostic and therapeutic purposes. METHODS. Respondents from the SA Society of Psychiatrists (SASOP) completed a purpose-designed questionnaire anonymously online. Respondents were compared statistically with regard to whether they identified with a religion, and the regularity of their participation in religious activities. Further comparisons were made based on gender and years of clinical experience. RESULTS. Participants who identified with a religion showed no statistical differences in comparison with those who did not, regarding: how they viewed the importance of a patient’s religious beliefs for purposes of diagnosis, general management, psychotherapy, pharmacotherapy, recovery from an acute episode, maintenance of recovery or remission, time to be spent on religious education, referral for religious/ spiritual counselling according to patient’s own beliefs; referral when patient and participant are of different religions; and whether referral is considered harmful when a patient’s religious beliefs are similar to or different from the participant’s. Statistically significant differences were found where participants who did not identify with a religion were more likely to indicate religion had ‘little importance’ for the purpose of understanding the patient and to indicate ‘no’ when asked if they would refer a patient for religious/spiritual counselling. When comparing regularity of participation in religious gatherings, participants who indicated their participation as ‘no/never’ were more likely to answer ‘no’ when asked if they would refer a patient for religious/spiritual counselling, even when of a similar religion to that of their patient. In comparing genders, males were more likely to answer ‘yes’ than females when asked if they considered religious/spiritual counselling (in accordance with the patient’s own religious beliefs) potentially harmful when the patient’s religion was different from the participant’s. CONCLUSION. It appears that SA psychiatrists’ identification with religion and regularity of participation in religious gatherings do not influence their approach to religious matters of their patients in most respects. The exception seems to be for those psychiatrists who do not identify with a religion (~16%), who tend to respond that they do not refer for religious counselling and that they consider the patient’s religious identification to be of little importance in understanding the patient.http://www.sajp.org.zahb201

Pattern recognition of estradiol, testosterone and dihydrotestosterone in children's saliva samples using stochastic microsensors

Stochastic microsensors based on diamond paste and three types of electroactive materials (maltodextrin (MD), α-cyclodextrin (α-CD) and 5,10,15,20-tetraphenyl-21H,23H porphyrin (P)) were developed for the assay of estradiol (E2), testosterone (T2) and dihydrotestosterone (DHT) in children's saliva. The main advantage of utilization of such tools is the possibility to identify and quantify all three hormones within minutes in small volumes of childen's saliva. The limits of quantification obtained for DHT, T2, and E2 (1 fmol/L for DHT, 1 pmol/L for T2, and 66 fmol/L for E2) determined using the proposed tools allows the utilization of these new methods with high reliability for the screening of saliva samples from children. This new method proposed for the assay of the three hormones overcomes the limitations (regarding limits of determination) of ELISA method which is the standard method used in clinical laboratories for the assay of DHT, T2, and E2 in saliva samples. The main feature of its utilization for children's saliva is to identify earlier problems related to early puberty and obesity

Cell and gene therapies at the forefront of innovative medical care: Implications for South Africa

The fields of cell and gene therapy are moving rapidly towards providing  innovative cures for incurable diseases. A current and highly topical  example is immunotherapies involving T-cells that express chimeric antigen receptors (CAR T-cells), which have shown promise in the treatment of leukaemia and lymphoma. These new medicines are indicative of the changes we can anticipate in the practice of medicine in the near future. Despite their promise, they pose challenges for introduction into the healthcare sector in South Africa (SA), including: (i) that they are  technologically demanding and their manufacture is resource intensive; (ii) that the regulatory system is underdeveloped and likely to be challenged by ethical, legal and social requirements that accompany these new therapies; and (iii) that costs are likely to be prohibitive, at least initially, and before economies of scale take effect. Investment should be made into finding novel and innovative ways to introduce these therapies into SA sooner rather than later to ensure that SA patients are not excluded from these exciting new opportunitie

Stress Distribution in Mandible Regulated by Bone and Dental Implant Parameters: Part I - Methodology

The complicated inter-relationships between mandibular bone components and dental implants have attracted the attention of many a structural mechanics researcher as well as many a dental practitioner. This paper describes the methodology and analysis techniques employed to enable accurate evaluation of a vast range of the implant and bone parameters. The complex material and geometric properties of the bone and implant are modelled using two-dimensional (2D) triangular and quadrilateral plane strain elements. Assumptions made in the analysis include: (a) 50% osseointegration between bone and implant; (b) linear relationships exist between the stress value and the Young’s moduli of the cancellous and cortical bone at any specific point. In the companion paper (Part II) various bone, implant and loading parameters are evaluated for their influence on the stress distribution within the bone, in particular in the mandible

Natural organic matter in drinking water sources: its characterisation and treatability

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Cell and gene therapies at the forefront of innovative medical care: Implications for South Africa

The fields of cell and gene therapy are moving rapidly towards providing innovative cures for incurable diseases. A current and highly topical example is immunotherapies involving T-cells that express chimeric antigen receptors (CAR T-cells), which have shown promise in the treatment of leukaemia and lymphoma. These new medicines are indicative of the changes we can anticipate in the practice of medicine in the near future. Despite their promise, they pose challenges for introduction into the healthcare sector in South Africa (SA), including: (i) that they are technologically demanding and their manufacture is resource intensive; (ii) that the regulatory system is underdeveloped and likely to be challenged by ethical, legal and social requirements that accompany these new therapies; and (iii) that costs are likely to be prohibitive, at least initially, and before economies of scale take effect. Investment should be made into finding novel and innovative ways to introduce these therapies into SA sooner rather than later to ensure that SA patients are not excluded from these exciting new opportunities

Cell and gene therapies at the forefront of innovative medical care : implications for South Africa

The fields of cell and gene therapy are moving rapidly towards providing innovative cures for incurable diseases. A current and highly topical example is immunotherapies involving T-cells that express chimeric antigen receptors (CAR T-cells), which have shown promise in the treatment of leukaemia and lymphoma. These new medicines are indicative of the changes we can anticipate in the practice of medicine in the near future. Despite their promise, they pose challenges for introduction into the healthcare sector in South Africa (SA), including: (i) that they are technologically demanding and their manufacture is resource intensive; (ii) that the regulatory system is underdeveloped and likely to be challenged by ethical, legal and social requirements that accompany these new therapies; and (iii) that costs are likely to be prohibitive, at least initially, and before economies of scale take effect. Investment should be made into finding novel and innovative ways to introduce these therapies into SA sooner rather than later to ensure that SA patients are not excluded from these exciting new opportunities.Work in MSP’s group is funded by the South African Medical Research Council (University Flagship and Extramural Unit awards).http://www.samj.org.zaam2019ImmunologyPaediatrics and Child Healt

Ethical considerations in the application of cell and gene therapies in children

Rapidly evolving fields such as cell and gene therapies that involve state-of-the-art technology hold out possibilities that may be ahead of what ethics, guidelines and the law have considered. This results in a regulatory lag. Furthermore, ethical and legal considerations are often debated in real time as issues pertaining to these technologies that were previously not considered begin to come to the fore. Finding the appropriate balance between facilitating potential therapeutic gains and ensuring the safety interests of recipients of the new treatments requires close attention, especially for minors. This vulnerable population frequently has off-label treatment prescribed on the basis of extrapolation of clinical trial data derived from adults, which is ethically and scientifically questionable. In this article we discuss how best to maintain ethical integrity while introducing innovative cell and gene therapies to minors. We advocate that clinical trials of promising innovative therapies should be designed so that testing in adults is followed as soon as possible by testing in minors, given the impressive gains that have recently been reported