Anatomical human body donation in South Africa: Inconsistencies of informed consent.

INTRODUCTION: Informed consent is critical for maintaining the ethical standards associated with the utilization of human donor bodies by tertiary education institutions. Body donation programs undertake the responsibility for procuring human donor bodies for didactic and research purposes. However, its processes require scrutiny regarding best practice guidelines and the South African National Health Act (SA-NHA) (2013). Moreover, acknowledging and addressing the current perceptions of human body donation are indispensable in bridging the gap between academia and society. This study aimed to compare informed consent documentation and procedures across South African tertiary education institutions and their affiliated human body donation programs (HBDP) in accordance with international guidelines. The findings were used to create a human body donation form template aligned to current international best practices for consideration by the South African HBDP. METHODOLOGY: A review of information and consent forms collected from South Africa's eight HBDP was conducted. The analyses consisted of a broad evaluation of information provided, ranging from the terms-of-use for human donor bodies to the commitments made by HBDP to body-donors. The results were considered in conjunction with the International Federation of Associations of Anatomists and other recent publications on informed consent in HBDP. RESULTS: Only two of the eight HBDP provided information and consent forms in more than one language. Most allowed donors to select how their bodies will be utilized - education, training and/or research. Some (6/8) made provisions for the next-of-kin to receive the cremains. Only one tertiary educational institution mentioned the occurrence of a memorial service in its documentation. An HBDF template was created aligned to current international best practices for presentation and possible adaption by SA HBDP. DISCUSSION & CONCLUSIONS: Human body donation forms (HBDF) requires thorough examination for the promotion and sustainability of HBDP. Effective communication by employing standardized non-technical terminology conveyed in language that is understandable and native to potential donors facilitates the deliverance of informed consent. Inconsistencies regarding the use and management of bodies catalyze the weakening perception of human body donation. Thus, this process of securing informed consent for body donation should be conducted in conjunction with public awareness campaigns and underpinned by the necessary policy and legislative reform.

The European Grief Conference, Copenhagen 2022: An effort to unite the field of bereavement care in Europe.

Bereavement care in Europe varies in quality and availability. Through greater collaboration across Europe, there could potentially be an opportunity to improve care. This article discusses the inaugural European Grief Conference held in Denmark in 2022: "Bereavement and Grief in Europe - Emerging Perspectives & Collaborations". The conference was structured around a 4-tiered public health model of bereavement care needs. It included practice, research, policy, and educational perspectives. A total of 250 people from 27 different countries participated. To determine if the conference had appealed to a broad European audience of grief professionals and to assess how the conference was received by participants, we examined registration/submission data, the results of a one-word real-time feedback exercise, and the answers to an online satisfaction survey. The results indicated wide interest in greater information sharing and collaboration across Europe among bereavement care, research, and education professionals.

Comparing solutions to the expectancy-value muddle in the theory of planned behaviour.

OBJECTIVES: The authors of the Theories of Reasoned Action (TRA) and Planned Behaviour (TPB) recommended a method for statistically analysing the relationship between the indirect belief-based measures and the direct measures of attitude, subjective norm, and perceived behavioural control (PBC). However, there is a growing awareness that this yields statistically uninterpretable results. This study's objective was to compare two solutions to what has been called the 'expectancy-value muddle'. These solutions were (i) optimal scoring of modal beliefs and (ii) individual beliefs without multiplicative composites. DESIGN: Cross-sectional data were collected by telephone interview. METHODS: Participants were 110 first-degree relatives (FDRs) of patients diagnosed with colorectal cancer (CRC), who were offered CRC screening in the study hospital (83% response rate). Participants were asked to rate the TPB constructs in relation to attending for CRC screening. RESULTS: There was no significant difference in the correlation between behavioural beliefs and attitude for rescaled modal and individual beliefs. This was also the case for control beliefs and PBC. By contrast, there was a large correlation between rescaled modal normative beliefs and subjective norm, whereas individual normative beliefs did not correlate with subjective norm. CONCLUSIONS: Using individual beliefs without multiplicative composites allows for a fairly unproblematic interpretation of the relationship between the indirect and direct TPB constructs (French & Hankins, 2003). Therefore, it is recommended that future studies consider using individual measures of behavioural and control beliefs without multiplicative composites and examine a different way of measuring individual normative beliefs without multiplicative composites to that used in this study.

Patients' experiences of dialysis services: are national health strategy targets being met?

BACKGROUND: The National Health Strategy envisages a health system incorporating patient views; and providing accessible, consultant-led dialysis services with patient choice of dialysis modality, in all regions. AIMS: To describe patients' experiences of renal services against National Health Strategy objectives. METHODS: Telephone interviews with 192 dialysis patients from three hospitals in the Eastern region. RESULTS: One-quarter of participants (16% of haemodialysis [HD] and 46% of peritoneal dialysis patients) lived outside the Eastern region, and travelled there because dialysis was not available locally. Two-thirds (65%) had a choice of dialysis modality. High satisfaction with interpersonal care was observed (83-98% satisfaction). Dissatisfaction with physical environment included parking (39-56%), waiting areas (62-69%), HD unit space (74%). Regarding support services, dietary services were satisfactory (92-95%), with lower satisfaction ratings for social and financial support services (62%). CONCLUSIONS: Structural and management issues must be addressed to advance a quality agenda for renal care in Ireland.

Relatives' views of health care in the last year of life.

This article reports the views of 155 relatives of patients who died during a 12-month period with varying degrees of palliative care service (hospital-based, home care and no palliative care). Although overall care was rated as excellent or good by the majority of interviewees, the Critical Incident Technique (Flanagan, 1954) was used to gather examples of good and poor care from relatives' perspectives. These incidents are recounted here under a framework describing the process of care from access to services through to care at the time of death and aftercare for relatives. The range of incidents reported suggest that relatives consider all aspects of care - technical and interpersonal - as important towards the end of life, but particular importance is placed on the attitudinal and dignity-preserving aspects of care. The movement to integrate principles of palliative care into all clinical practice is reinforced by the findings from this study.