Realising the Right to Health for Young People in South Africa—Some Reflections

Abstract

The right to health is enshrined in the South African Constitution as well as a range of international and regional human rights treaties which South Africa accepts. Yet empirical data reveals some of the challenges faced by South African youth—childhood diseases, HIV/AIDS and such like. There are evidently challenges realising the right to health in practice. Nevertheless, South African courts have led the international field in recognising the justiciability of economic and social rights such as the right to health. Having reviewed the applicable laws and jurisprudence, the paper will conclude that a more holistic human rights-based approach offers perhaps the best way forward.     

Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. Yet it occasionally seems morally permissible to carry out non-consensual medical interventions on competent individuals for the purpose of infectious disease control (IDC). We describe two different moral frameworks that have been invoked in support of non-consensual IDC interventions and identify five desiderata that might be used to guide assessments of the moral permissibility of such interventions on either kind of fundamental justification. We then consider what these desiderata imply for the justifiability of carrying out non-consensual medical interventions that are designed to facilitate rehabilitation amongst serious criminal offenders. We argue that these desiderata suggest that a plausible case can be made in favor of such interventions.     

ICF脑卒中核心分类组合功能的图形建模研究

目的依据《国际功能、残疾和健康分类(ICF)》脑卒中核心组合,探讨脑卒中相关功能类目之间的关系,绘制ICF脑卒中核心分类组合的功能地形图,为脑卒中的伤残评定提供科学理论依据。方法收集106例脑卒中被鉴定人样本,采用"最小的绝对缩减和变量选择算子",研究脑卒中ICF核心组合功能的59项类目变量之间的条件依存关系,并用图形建模分析类目之间的内在联系,绘制功能地形图。结果 59项类目之间的相互联系构成了功能地形图,b340、b735、b175和b152因关联性较高而居于地形图的中心位置。结论脑卒中功能地形图可以揭示ICF功能类目之间复杂的关系结构及关联程度。可以为应用ICF进行脑卒中的伤残评定提供科学理论依据。     

'Your personality is the intervention': a grounded theory of mental health nurses’ beliefs about hope and experiences of fostering hope within a secure setting

Hope is an important factor in psychological resilience and change, and recovery from mental health difficulties. Recently, there has been an increased focus on recovery-oriented practice within forensic mental health settings. Several policies include calls for mental health practitioners to inspire hope for recovery in the individuals they work with. However, there is little suggestion of how to implement such recommendations in practice or research exploring how staff foster hope in forensic settings. This study used grounded theory to explore nurses’ perspectives and experiences of hope within a medium secure setting. A model was developed from the data that integrated nurses’ beliefs about hope, practices to develop service users’ hope and the emotional impact of this work. The nurses’ values played a significant role in their work to develop hope. Recommendations are made to help manage the emotional impact and address challenges unique to fostering hope within forensic settings.     

Therapeutic engagement in medium-secure care: an interpretative phenomenological analysis of service users’ experiences

Service users (SUs) detained in forensic hospitals are usually required to engage in psychological therapies aimed at reducing mental distress and/or for preventing further offending. Poor therapeutic engagement (TE) can lead to adverse clinical outcomes and reoffending, at a cost to the individual, staff, the service provider, and the public. To understand what factors influence TE from a SUs’ perspective, the experiences of 10 male residents of a medium-secure hospital were explored. Using a service-user informed design, interpretative phenomenological analysis of interview data was completed. Four superordinate themes emerged: different worlds; what the individual brings; what the therapy entails; and control. Consideration of how these factors may be of use to professionals working in secure care settings is discussed in relation to existing theory and research.     

“Supporting me through emotional times,all different kinds of behaviour.” Forensic mental health service users understanding of positive behavioural support

This service evaluation project explored service users’ experiences of positive behavioural support (PBS) within a medium secure mental health service. Interpretative phenomenological analysis (IPA) was used to analyse interviews with ten service users. Four main themes emerged from the data: My plan; How I understand PBS; How PBS has helped me, the benefits; and Making the plan work. Overall, service users viewed their experience of having a PBS plan positively. They reflected that the plans offered staff greater understanding of their behaviours and needs, enabling them to receive appropriate support. Service users valued the experience of being involved in the process, offering important insights into their experiences. They also expressed frustrations about staff not following the plan and not understanding why they had a plan whilst others did not. Limitations of the study, clinical implications and ideas for future research have been discussed.     

Transfers from prison to hospital under Sections 47 and 48 of the Mental Health Act between 2011 and 2014

In England and Wales, prisoners with mental disorder of such severity as to warrant inpatient treatment may be transferred to hospital under the Mental Health Act. UK Government guidance recommends that this process should be completed within 14 days; however, evidence suggests that in many cases it can take much longer. This retrospective service evaluation of 64 male prisoners, who were transferred under Section 47 or Section 48, aimed to evaluate transfer durations. The mean time from referral to admission was 76 days. Prisoners with a psychotic disorder were admitted more quickly. Remand prisoners were admitted more quickly than sentenced prisoners. Findings suggest that, in the UK the transfer time of prisoners under Sections 47 and 48 of the Mental Health Act continues to far exceed the 14-day target which raises concern about equivalence of care for prisoners. Our findings support arguments for fundamental amendments to the admissions process.     

公安院校毕业生心理健康状况调查——以福建警察学院为例

采用SCL-90症状自评量表对我校568名专科毕业生进行测试,并与全国成人常模对照分析,我校毕业生心理健康状况总体良好,但有一部分学生存在心理问题;在男女毕业生中,女生的强迫症状、人际敏感、抑郁、焦虑、恐怖、精神病性因子均显著高于男生。加强对公安院校学生的心理健康教育工作刻不容缓。     

析校园文化对提升思想政治教育实效的作用

校园文化在大学生思想政治教育中发挥着重要作用。校园文化的实践特征使思想政治教育活动能够获得丰富的实践形态,为实现思想政治教育的内化提供了有效途径;同时,校园文化体现了思想政治教育造就和谐个体的目标,是显性教育和隐性教育相结合的最好形式。     

国际卫生法的新使命:全球公共健康治理

世界卫生组织在20世纪通过两个国际规章来控制疾病的跨国传播,本世纪通过了《国际卫生法规（2005）》与《烟草控制条约》。目前面临的最大挑战是能否处理好世界上最贫穷国家、地区和人民的公共健康问题,满足其基本生存需要。建议其与国际组织、国家、企业、基金、民间组织合作,达成全球公共健康框架公约,有效改善穷国的卫生条件,帮助他们进行能力和机构建设,这是世界卫生组织和国际卫生法在新的条件下必须承担的新使命和发展的新契机。