Becoming a Xhosa traditional healer : the calling, illness, conflict and belonging

CITATION: Van der Watt, A. S. J. et al. 2021. Becoming a Xhosa traditional healer : the calling, illness, conflict and belonging. South African Journal of Psychiatry, 27:a1528, doi:10.4102/sajpsychiatry.v27i0.1528.The original publication is available at https://sajp.org.zaBackground: Traditional healers (THs) are an important part of the healthcare system in sub-Saharan Africa. Understanding their training, experiences of becoming healers and their perceived roles in society is critical. Aim: This study aimed to explore the experience of becoming a TH, including accepting the calling, and sheds light on how the experience is conceptualised within the cultural and communitarian context of THs. Setting: This study was conducted amongst Xhosa THs in the Western Cape, South Africa. Methods: In-depth phenomenological interviews (n = 4) were conducted with Xhosa THs and analysed using Giorgi’s descriptive pre-transcendental Husserlian phenomenological analysis. Results: The experience of becoming a TH can be summarised in the context of three units of significance: (1) the gift of healing as an illness; (2) the experience of conflict (including with their families, the church and self-conflict); and (3) the experience of belonging. Familial conflict, specifically, was fuelled by the financial burden of becoming a TH and a lack of understanding of the process. Conclusion: To develop a workable model of collaboration in the future, it is crucial that mental healthcare providers develop a better understanding of the experiences of THs in becoming care providers. The findings highlight an appreciation of the challenging process of becoming a TH. Finally, further research and culturally appropriate psychoeducation can provide trainee THs and their family members with the skills and knowledge to support each other through a difficult process.https://sajp.org.za/index.php/sajp/article/view/1528Publisher's versio

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Women’s experience of being single

Thesis (MA)--Stellenbosch University, 2015ENGLISH ABSTRACT : Women‟s experience of being single has generally been neglected by psychological research and literature. However, the study of singlehood could provide valuable information about interpersonal relationships and the personal realm. Forming a romantic relationship is deemed an important developmental and social task within Western society which holds that all human beings have an inherent need for intimacy and belonging. The lack of such a relationship often leads to social stigmatization and marginalization. Whilst various studies of romantic relationships have been conducted, very few studies have focussed on singlehood. The few studies on singlehood often pose methodological problems. Situated in a feminist informed phenomenological framework; this study investigated women‟s experience of being single. Seven tertiary-educated, single women between the ages of 30 and 40 years were interviewed individually regarding their experience of being single. The interviews were then analysed by means of Giorgi‟s descriptive pre-transcendental phenomenological method. The participants‟ rich and nuanced descriptions of how they experienced being single were grouped into eight units of significance: being single means not being in a relationship; holding on to the “you can” freedom; a partner implies obliged companionship and support; (un)wanted attention from the right man; we are educated and independent women!; (not) wanting children, either way, time‟s running out; missing out on sex; and reasons for being single. The results highlighted the hegemony of romantic relationships, the prevalence of a dominant gender discourse, and also the tension between freedom and connectedness which women often experience. Lastly, the limitations and future recommendations of the study are presented.AFRIKAANSE OPSOMMING : Vroue se ervaring van enkellopendheid word meestal in sielkundige navorsing en -literatuur verwaarloos. Tog kan die bestudering van enkellopendheid waardevolle inligting ten opsigte van interpersoonlike verhoudinge en die verstaan van die persoon-sfeer bied. In ʼn Westerse konteks word die aangaan van romantiese verhoudings as ʼn belangrike ontwikkelings- en sosiale taak beskou. Dit impliseer dat alle mense ʼn inherente behoefte aan romantiese intimiteit en verbondenheid het. Die gebrek aan sodanige verhoudinge lei dikwels tot sosiale stigmatisasie en marginalisering. In teenstelling met studies oor romantiese verhoudinge, het weinig op enkellopendheid gefokus. Die enkele studies wat wel oor enkellopendheid onderneem is, word dikwels deur metodologiese probleme gekenmerk. Gesitueer in ʼn feministies-fenomenologiese perspektief, ondersoek hierdie studie vroue se belewing van enkellopendheid en het ten doel om die metodologiese problematiek wat vorige studies ondervind het, aan te spreek. Daar is met sewe 30 tot 40 jarige enkellopend vroue, met tersiêre opleiding, individuele onderhoude oor hulle belewing van enkellopendheid gevoer. Die onderhoude is deur middel van Giorgi se beskrywende pre-transendentale fenomenologiese metode geanaliseer. Die deelnemers se ryke en genuanseerde beskrywings van hulle belewing van enkellopendheid is saam groepeer in agt betekenis-eenhede: enkellopendheid beteken om nie in ʼn verhouding te wees nie; ʼn vashou aan die “jy kan” vryheid; ʼn lewensmaat beteken verpligte saamwees en ondersteuning, (on)gewenste belangstelling van die regte man; ons is opgevoede en onafhanklike vroue!; (nie) behoefte aan kinders (nie), wat ook al, die tyd loop uit; ontbering van seks; en redes vir enkellopendheid. Hierdie bevindinge is vanuit ʼn feministiese, fenomenologiese perspektief geïnterpreteer wat die volgende uitgelig het: die hegenomie van romantiese verhoudings in die hierargie van verhoudings, die voorkoms van ʼn dominante geslag diskoers, asook die spanning tussen vryheid en verbondenheid wat vrouens dikwels ervaar. Ten slotte word die beperkinge van hierdie studie, maar ook aanbevelings vir toekomstige studies, bespreek

Prospective interepisodal mood monitoring in patients with affective disorders : a feasibility study

CITATION: Van Der Watt, A. S. J., Suryapranata, A. P. S. P. & Seedat, S. 2017. Prospective interepisodal mood monitoring in patients with affective disorders : a feasibility study. Neuropsychiatric Disease and Treatment, 14:517-524, doi:10.2147/NDT.S152620.The original publication is available at https://www.dovepress.comPublication of this article was funded by the Stellenbosch University Open Access FundObjectives : Our primary objective was to assess the feasibility of interepisodal telephonic mood monitoring in patients with affective disorders in a low-resource setting. Secondary objectives included gathering data on longitudinal mood trajectories and assessing patient acceptance of mood monitoring. Methods: Inpatients with a primary mood or anxiety disorder were recruited predischarge. Assessment at intake included demographic information, the Life Events Checklist, and the Childhood Trauma Questionnaire. Participants telephonically completed the Altman Self-Rating Mania Scale (ASRM) and Quick Inventory of Depressive Symptomatology (QIDS), weekly, for 26 weeks. Units of alcohol consumed and life events were recorded. Semi-structured interviews were conducted midway through the mood monitoring protocol. Results: Of the 61 eligible participants (77% female; mean age =35.3 years), 28 completed 26 weeks of telephonic mood monitoring. Thirty-three participants (54.1%) withdrew prematurely or were lost to follow-up. Males were more likely to terminate study participation prematurely. Despite the significant decline in depression scores over 26 weeks, participants endorsed persistent mild-to-moderate depressive symptoms. Statistically, participants who were married/in a relationship had higher mean depression scores throughout the study compared to participants who were single. Throughout the study, ASRM scores were not indicative of significant mania. Suicidality (as measured by QIDS item 12) was highest at Week 3 and Week 12 postdischarge for those who completed 26 weeks of monitoring. Conclusion: Despite the high attrition rate, interepisodal telephonic mood monitoring was deemed to be feasible and it can provide useful information to track progress, encourage medication adherence, and manage early warning signs of relapse. Further research is required to determine the benefit of weekly mood monitoring on mood fluctuations and to examine strategies that enhance retention.https://www.dovepress.com/prospective-interepisodal-mood-monitoring-in-patients-with-affective-d-peer-reviewed-article-NDTPublisher's versio

Distant mood monitoring for depressive and bipolar disorders : a systematic review

CITATION: Van Der Watt, A. S. J., et al. 2020. Distant mood monitoring for depressive and bipolar disorders : a systematic review. BMC Psychiatry, 20:383, doi:10.1186/s12888-020-02782-y.The original publication is available at https://bmcpsychiatry.biomedcentral.com/Background: Broadening our knowledge of the longitudinal course of mood symptoms is cardinal to providing effective long-term treatments. Research indicates that patients with mental illness are willing to engage in the use of telemonitoring and mobile technology to assess and monitor their mood states. However, without the provision of distant support, adverse outcomes and events may be difficult to prevent and manage through self-monitoring. Understanding patient perspectives is important to achieving the best balance of self-monitoring, patient empowerment, and distant supporter involvement. Methods: This systematic review synthesises quantitative and qualitative evidence of the effectiveness and feasibility of daily/weekly/monthly remote mood monitoring that includes distant support in participants with mood disorders. Inclusion criteria comprised mood monitoring of mood disorder patients as main intervention, study design, method of monitoring, and presence of psychotherapy and psychoeducation. Effectiveness was defined by the change in depression and/or mania scores. Feasibility was determined on participant feedback and completion/attrition rates. Studies were assessed for quality using the Mixed Methods Appraisal Tool version 2018. Results: Nine studies of acceptable quality met the inclusion criteria. Distant mood monitoring was effective in improving depression scores but not mania scores. Feasibility, as measured through compliance and completion rates and participant feedback, varied. Conclusion: Distant mood monitoring with support may be a useful, acceptable, and feasible intervention for diverse groups of patients in terms of age and ethnicity. Further, it may be effective in improving symptoms of depression, increasing treatment adherence, and facilitating the prevention and management of adverse outcomes. As a task-shifting intervention, distant mood monitoring may help to alleviate the burden on mental health providers in developing countries.https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02782-yPublisher's versio

Supplementary_1_Discussion_Schedule – Supplemental material for Adolescents’ Experience of Stigma When Accessing School-Based PTSD Interventions

<p> Supplemental material, Supplementary_1_Discussion_Schedule for Adolescents’ Experience of Stigma When Accessing School-Based PTSD Interventions by Tanya van de Water, Jaco Rossouw, Alberta S. J. van der Watt, Elna Yadin and Soraya Seedat in Qualitative Health Research</p

Afri-Can Forum 2

CITATION: Mukudu, H., et al. 2016. Afri-Can Forum 2. BMC Infectious Diseases, 16:315, doi:10.1186/s12879-016-1466-6.The original publication is available at https://bmcinfectdis.biomedcentral.comENGLISH ABSTRACT: We are pleased to present peer reviewed forum proceedings of the 2nd synchronicity forum of GHRI/CHVIfunded Canadian and African HIV prevention and vaccine teams Forum objectives ∙GHRI-funded capacity building and HIV prevention research teams presented highlights of achievements ∙Teams discussed how to jointly build on achievements for sustainability ∙Provided an opportunity for inter-team collaboration, synchronize best approach to capacity building, mentoring of new researchers and building leadership ∙Provided opportunities for informal discussions and networking among the teams. ∙Teams learnt about recent advances in the area of African regulatory and ethics review process ∙The forum proceedings was a special supplement in an openaccess journal was producedhttps://bmcinfectdis.biomedcentral.com/articles/supplements/volume-16-supplement-2Publisher's versio