Psychologists' right to prescribe – should prescribing privileges be granted to South African psychologists?

Current changes in legislation regarding prescription rights increase the possibility of non-medical practitioners being authorised to presctibe medication. There has been ongoing debate about granting psychologists in South Africa a limited right to prescribe (RTP) psychotropic medication. The main reasons advanced for granting psychologists RTP include the advantage of delivering integrated treatments, with psychologistS well placed to offer such treatment, and the shortage of mental health practitioners in South Africa. If psychologists were granted the RTP they would have to undergo extensive training in psychopharmacology. Curricula for such training are currently being prepared with the help of the American Psychological Association. But there is also considerable opposition to psychologists being granted the RTP, both from within psychology and from other quarters. Opposition from outside psychology is based largely safety considerations relating to lack of relevant f trammg among psychologists. Opposition from within psychology is based on a concern about the loss of the distinctive contribution of psychology to mental health care Iin South Africa. Various aspects of this debate are examined in this paper

Losing One’s Culture: The Narrative Identity of Nigerian Catholic Religious Sisters

This chapter reports on part of the findings of a doctoral research focused on identity construction of Catholic religious sisters in the Church and in the wider Nigerian society. Primarily, the chapter interrogates how Catholic religious sisters negotiate their culture identity within the context of living religious life. Data were collected from 18 sister participants, who were purposefully recruited from two religious congregations across the different states of Nigeria. These included six temporary professed, six final professed and six leaders (including superiors/formators) representing the different categories of sisters that live religious life. The data were thematically analysed using the Dialogical Self Theory I-positions. The second sentence revealed tendencies for the participants to lose their cultural identity in terms of their struggles and sometimes compromises in identifying Western culture as the dominate culture of religious life. In this regard, the participants reported that their Nigerian communitarian culture of love, care and hospitality is regulated to the background. In response, this chapter calls for further research towards exploring the impact of culture on Catholic religious sisters’ expression of identity

Informed Consent in a Clinical Trial: Participants Satisfaction of the Consent Process and Voluntariness of Participation

A study was conducted among participants in an antiretroviral therapy (ART) clinical trial to determine how voluntary their participation was and their satisfaction to the consent process. A semi structured questionnaire was administered to 88 of the 180 people enrolled in the study at the time of interview and who were willing to participate. Participation in the study was driven mainly by unmet health needs and participant reported benefits (free drug and tests) as the primary motive to participate in the research. The absence of alternatives to access medical services creates challenges to voluntary participation. Most of the participants saw the consent process as satisfactory, the satisfaction might be based on the hope the treatment is giving them and on the trust they have on investigators and the institution. It is then of importance that research participants be given enough time to reflect on the information provided during the consent process before obtaining consent from them

Socio-behaviour challenges to phase III HIV vaccine trials in sub-Saharan Africa

Background: A number of countries in sub-Saharan Africa are preparing for HIV vaccine efficacy trials. Social and behavioural factors related to HIV transmission require examination in each setting where these trials are considered. As part of this, several countries have also recently begun preparatory research investigating relevant social and behavioural issues. There is a need for a review of the literature to help focus such research efforts in Sub-Saharan Africa. Objective: To examine key social and behavioural issues that may impact on the conduct of HIV vaccine efficacy trials in sub-Saharan Africa. Design: Literature review Methods: Major databases (PubMed, PsychInfo, EBSCOhost, and AIDSline) were searched for literature that discussed social and behavioural issues related to HIV vaccine trials. Three areas are highlighted as being particularly significant for HIV vaccine research: (1) willingness to participate in future HIV vaccine efficacy trials, (2) retention of participants in studies, and (3) sexual risk reporting during trials. For each of these topics, major findings from both developed and developing countries are described and avenues for further research are discussed. Results: There are few data from Sub-Saharan Africa regarding willingness to participate in HIV vaccine trials. Data on participant retention rates varies widely, and maintaining large cohorts of individuals within Phase III trials presents an important challenge. In addition, the possible impact of trial participation on sexual disinhibition, and response bias on sexual risk-reporting remain as issues for HIV vaccine trials in African contexts. Conclusions: Social and behavioural research forms an important part of preparations for HIV vaccine efficacy trials, and there is a clear need for more research of this type in Sub-Saharan Africa. Innovative approaches are required to address issues such as willingness to participate in vaccine research, participant retention during efficacy trials, and the accurate reporting by participants of sexual risk behaviours

Consent and community engagement in diverse research contexts: reviewing and developing research and practice

Consent and community engagement (CE) in health research are two aspects of a single concern—that research is carried out in a respectful manner where social value is maximized. There are important overlaps and interdependencies between consent and CE; for example, CE can provide insights into how best to tailor consent to context and can be an important component of consent processes. Engaging communities can also have intrinsic and instrumental value beyond consent; for example, as a means of showing respect and identifying appropriate ways of working respectfully. In this paper we critically examine how CE and consent processes are characterized, conducted, and evaluated in diverse health research contexts, and propose a preliminary research agenda to support future learning in these critical areas

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A Gender Analysis of Targeted AIDS Interventions (TAI)

This report looks at the work of the Targeted AIDS Intervention (TAI) Project, an NGO in Pietermaritzburg, Kwa Zulu-Natal, South Africa, which is dedicated to HIV education and training, especially with men and boys. It looks at the impact of TAI's work on both changing risk behaviour to reduce HIV, as well as the role their work plays in creating personal change toward broader sustained gender equality.TAI is one of the civil society initiatives supported by the Joint Oxfam HIV/AIDS Program (JOHAP) in South Africa.The report demonstrates that TAI's focus on boys is an appropriate, novel and progressive approach to dealing with HIV and AIDS. This review clearly shows the value of a partnership of academic institutions and NGOs in dealing with social crises, such as the HIV pandemic.This document is one of a number of publications highlighting learning during the second phase of JOHAP (April 2002-March 2005)

Informed consent in clinical trials: Perceptions and experiences of a sample of South African researchers

The implementation of informed consent (IC) in clinical trials presents many challenges, especially in developing countries. This study explored the experiences and reported practices regarding the implementation of IC in clinical trials in South Africa. Data were gathered through semi-structured interviews with a range of stakeholders in clinical trials in two provinces. The interviews were analysed to identify themes and issues relating to IC. The findings show that IC practices involve attention being paid to both formal requirements and informal practices to attain IC. Research assistants or trial counsellors were found to play a critical role in facilitating the IC process. It is recommended that more recognition be given to the important role of trial counsellors in clinical trials, and that they be given more formal training, support and supervision. Opsomming Die implementering van ingeligte toestemming (IT) in kliniese proewe bied menige uitdagings, veral in ontwikkelende lande. Hierdie studie het die ervarings en vermelde praktyke betreffende die implementering van IT in kliniese proewe in Suid-Afrika ondersoek. Data is ingewin deur middel van semi-gestruktureerde onderhoude met 'n verskeidenheid van rolspelers in kliniese proewe in twee provinsies. Onderhoude is ontleed om herhalende temas rakende IT te identifiseer. Bevindings toon dat IT-benaderings die voldoening aan formele vereistes sowel as die gebruikmaking van informele metodes behels. Daar is bevind dat navorsingsassistente 'n kritieke rol in die fasilitering van die IT-proses speel. Daar word aanbeveel dat meer erkenning gegee word aan die rol van proefvoorligters in kliniese proewe, dat hulle meer formele opleiding ondergaan, dat hulle beter ondersteuning ontvang en dat daar beter oor hulle toesig gehou word