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Biomedical subjects

L Swartz

Publications and source records attributed to L Swartz.

At least 37 records · Page 2Linked to original sources
PubMed1991

The politics of black patients' identity: ward-rounds on the 'black side' of a South African psychiatric hospital.

There are many macrosocial studies of the political organisation of health and mental health care in South Africa, and the maldistribution of resources by race is well known. Little attention, however, has been given to the minutiae of the negotiation of power in the clinical setting. This article, which reports on part of a larger study of aspects of culture in South African psychiatry, focuses on interactions in ward-rounds on the 'Black side' of a South African psychiatric hospital. Through analysis of cases, the complexity of interpreting what transpires in such a setting and the central role that the concept of culture has in debates amongst staff members are demonstrated. Close analysis demonstrates the inadequacy of models which seek to locate the institutional racism of apartheid psychiatry in the motives of individual clinicians. Clinicians may simultaneously reproduce and subvert aspects of apartheid practice. A consideration of the social positioning of the clinician both as a South African and as a practitioner of psychiatry is central to the development of psychiatry in a post-apartheid South Africa.

Black or African American↗
PubMed1991

Cree Indian healing practices and western health care: a comparative analysis.

In this article, Cree Indian methods of treating disease are compared with the treatment process and procedures used in the Western health Care system. Ethnographic data permitted the identification of the five components of Cree healing: the ritual, contract, treatment, didactic, and closure components. These components are compared with equivalent phases in the physician-patient and nurse-patient relationship. In particular, the process of comparison permits the identification of incongruities that the Cree may encounter when using the Western system. These include the inability to identify one's own state of health and abnormalities; a passive, rather than a participatory role in healing; the incomprehensible notion of "silent" diseases and preventative treatment; the specialization of the caring, curing, and counselling roles of practitioners and the limited perspective of "holism" in health care.

Attitude to Health↗
PubMed1989

Political repression and children in South Africa: the social construction of damaging effects.

This article discusses some dilemmas facing mental health and social service workers studying and providing services for children affected by political repression in South Africa. We argue that it is almost inevitable that progressive care providers are affected by an image of childhood as one of passive innocence and vulnerability, an image which is both outmoded in terms of modern developmental psychology and potentially destructive if the aim of intervention is empowerment. Practical experience with children affected by repression has led us to question commonly held views on the nature of psychological damage, and to recognise that our views on stress tend to be class-bound. Questions of partiality and credibility affect both practical work and the way that social service workers conceive of their role. Without an approach to the understanding of repression which takes account of underlying ideological factors, the social construction of illness and symptoms, and the historical antecedents of current abuses of children in South Africa, we are unable adequately to situate and evaluate critically the work we are doing. Even the focus on children as particular victims of apartheid needs to be thoroughly examined.

Child↗
PubMed1989

The consequences for preschool children of a parent's detention: a preliminary South African clinical study of caregivers' reports.

Semi-structured interviews on the consequences for preschool children of a parent's detention were conducted with primary caregivers of 19 South African children aged 2-6 yrs. Caregivers reported emotional problems, separation anxiety and fear as well as physical problems, aggression, secondary enuresis and developmental difficulties. Adaptive mechanisms are described. Fantasies focused chiefly on children's images of the detention situation, and on plans to alter current circumstances. Children who felt secure in the environment seemed generally to adjust better to the experience, particularly in the long term.

Adaptation, Psychological↗
PubMed1987

Talk about talk: metacommentary and context in the analysis of psychotic discourse.

This paper presents an analysis of an interview with a manic patient at a time when her discourse seemed incoherent. It addresses itself to the interface between discourse and context, and argues that adequate contextualization of discourse can render incoherent speech more understandable. Appraisal of context and analysis of metacommentary--speakers' references to the ongoing talk--makes apparently incoherent discourse intelligible, and gives access to the patient's experience of her illness. The implications of discourse analysis for psychiatric research are explored. General goals for discourse analysis in psychiatric settings are suggested, and strengths and weaknesses of the approach discussed.

Adult↗
PubMed1987

Illness negotiation: the case of eating disorders.

This article explores the possible relationship between professional writing on eating disorders and the occurrence of symptoms. The clinical situation is seen as one in which negotiation about symptoms affects and is affected by both professional and popular explanatory models. Professional understanding is not necessarily categorically distinct from popular conceptions. Furthermore, it may be that different academic models hold different assumptions about normality and may expect different types of 'normal' behaviour from patients. Professional writing and educative material may be playing a function not dissimilar from material generally seen as exploitative in educating women into development of symptoms. This possibility has implications for the way that professional understanding is viewed and contextualized.

Anorexia Nervosa↗
PubMed1987

Depression in the elderly living in the community. Its presentation and features.

A prevalence of depression of 13% was found among 139 coloured persons aged 65 years and over, living in the community in Cape Town, which accords with figures elsewhere. A high rate of hypochondriasis was found, but there was a low rate of suicidal intent, which could be explained by good social support. Observed depression and a depressed mood occurred in almost all depressed patients; as defined in the Present State Examination, these items appear to be an excellent screen for depression.

Activities of Daily Living↗
PubMed1986

Crystalluria in marathon runners. 1. Standard marathon--males.

Epidemiological evidence suggests that marathon runners have a higher incidence of renal stone formation than occurs in the general population. Since crystalluria and stone disease are thought to be related, we subjected urine samples from a group of marathon runners to particle counting and sizing in a Coulter Counter equipped with a population accessory unit. The volume-size distribution curves so obtained were bimodal with one peak occurring in the 2-5 micron diameter range and a second in the 15-32 micron diameter range - a pattern that is remarkably similar to the distributions reported for recurrent idiopathic stone formers and distinctly different to those recorded for control subjects. Analyses by scanning electron microscopy and X-ray powder diffraction revealed other features which are regarded as typical of stone formers' crystalluria. These physicochemical data indicate that marathon runners may be at increased risk of urinary stone formation.

Adult↗
PubMed1985

Issues for cross-cultural psychiatric research in South Africa.

South Africa's heterogenous society offers many opportunities for cross-cultural psychiatric research, but researchers in the country are subject to a number of restraints. Apart from legally enforced segregation, there are strict censorship laws and restricted access to certain types of information. The issues surrounding categorization of cultures and factors affecting publishing research from South Africa have important implications for the type of work that is done. It is a central argument of this article that the issues affecting research in South Africa are relevant to other countries as well, and parallels between the local and international context are drawn. The South African experience suggests that analysis of the research enterprise itself is a useful part of the business of cross-cultural psychiatric research.

Cross-Cultural Comparison↗
PubMed1985

Anorexia nervosa as a culture-bound syndrome.

Current psychological theories on anorexia nervosa share a common assumption that symptoms of the condition are related to cultural factors. The present article argues that the disorder can be fruitfully understood in the context of one definition of culture-bound syndromes. By way of introduction two contrasting models of the cross-cultural study of psycho-pathology are outlined in order to contextualize the argument in a particular paradigm. Anorexia nervosa is shown to fit the criteria of the Cassidy/Ritenbaugh definition of culture-bound syndromes, and the definition is shown to have some use in elucidating issues. Implications for a more flexible approach to theory development and therapeutic practice are discussed, and suggestions are made for further work demonstrating the negotiated nature of the disorder.

Anorexia Nervosa↗
PubMed1985

Subcultural delusions and hallucinations. Comments on the Present State Examination in a multi-cultural context.

The challenges presented by the Present State Examination (PSE) in a multi-cultural context are explored. The general approach to the use of this instrument, difficulties with rating items relevant to cultural or subcultural conditions, and particularly the assessment of psychosis are considered, as well as the possibility of additions to and modifications of the PSE-CATEGO system. Though disagreement exists as to whether the research model which the PSE represents is adequate to deal exhaustively with cultural factors, the instrument is useful in cross-cultural research and also in stimulating debate and crystallizing issues.

Cross-Cultural Comparison↗
PubMed1983

The coloured elderly in Cape Town--a psychosocial, psychiatric and medical community survey. Part II. Prevalence of psychiatric disorders.

A study of the prevalence of psychiatric disorders among 139 non-institutionalized Coloured persons aged 65 years and over was undertaken. Standard instruments, namely the Present State Examination and the Mini-Mental State Examination, were used with modifications. Dementia was judged to be present in 8.6% and severe in 3.6% of the subjects. Other psychiatric disorders (apart from alcoholism) were present in 24%, depression being the most common (16.5%). The prevalence of paranoid illness (2.2%) may be partly explained by the high rate of alcoholism among the men (15%). Most of the 16% who had previously received psychiatric inpatient treatment were judged to be disordered at present, and a relatively small proportion of the respondents (6%) were currently on psychotropic medication, with only 1 subject receiving antidepressants.

Black or African American↗
PubMed1983

The coloured elderly in Cape Town--a psychosocial, psychiatric and medical community survey. Part I. Introduction and psychosocial data.

A survey of 150 non-institutionalized Coloured persons over the age of 65 years living in Cape Town was undertaken to examine their psychosocial, psychiatric and medical condition. This article covers procedural and psychosocial aspects; Parts II and III will deal with others. Overall, respondents were poorly educated, with low income and occupational status. Social functioning and life satisfaction were reported to be good in over 80%. Family and social support appeared to be strong. Many respondents were involved in household duties (87%), child care (46%) and activities outside the home (66%). The high degree of satisfaction in the face of economic adversity may be due to family support and role maintenance. Findings are compared with those of previous studies, and the possibility that changes in circumstances are occurring is noted.

Black or African American↗