Managing conflicts between economic activities and threatened migratory marine species toward creating a multiobjective blue economy

Harnessing the economic potential of the oceans is key to combating poverty, enhancing food security, and strengthening economies. But the concomitant risk of intensified resource extraction to migratory species is worrying given these species contribute to important ecological processes, often underpin alternative livelihoods, and are mostly already threatened. We thus sought to quantify the potential conflict between key economic activities (5 fisheries and hydrocarbon exploitation) and sea turtle migration corridors in a region with rapid economic development: southern and eastern Africa. We satellite tracked the movement of 20 loggerhead (Caretta caretta) and 14 leatherback (Dermochelys coriacea) turtles during their postnesting migrations. We used movement-based kernel density estimation to identify migration corridors for each species. We overlaid these corridors on maps of the distribution and intensity of economic activities, quantified the extent of overlap and threat posed by each activity on each species, and compared the effects of activities. These results were compared with annual bycatch rates in the respective fisheries. Both species' 3 corridors overlapped most with longline fishing, but the effect was worse for leatherbacks: their bycatch rates of approximately 1500/year were substantial relative to the regional population size of <100 nesting females/annum. This bycatch rate is likely slowing population growth. Artisanal fisheries may be of greater concern for loggerheads than for leatherbacks, but the population appears to be withstanding the high bycatch rates because it is increasing exponentially. The hydrocarbon industry currently has a moderately low impact on both species, but mining in key areas (e.g., Southern Mozambique) may undermine >50 years of conservation, potentially affecting >80% of loggerheads, 33% of the (critically endangered) leatherbacks, and their nesting beaches. We support establishing blue economies (i.e., generating wealth from the ocean), but oceans need to be carefully zoned and responsibly managed in both space and time to achieve economic (resource extraction), ecological (conservation, maintenance of processes), and social (maintenance of alternative livelihood opportunities, alleviate poverty) objectives.

Transoceanic Migration, Spatial Dynamics, and Population Linkages of White Sharks

The large-scale spatial dynamics and population structure of marine top predators are poorly known. We present electronic tag and photographic identification data showing a complex suite of behavioral patterns in white sharks. These include coastal return migrations and the fastest known transoceanic return migration among swimming fauna, which provide direct evidence of a link between widely separated populations in South Africa and Australia. Transoceanic return migration involved a return to the original capture location, dives to depths of 980 meters, and the tolerance of water temperatures as low as 3.4 degrees C. These findings contradict previous ideas that female white sharks do not make transoceanic migrations, and they suggest natal homing behavior.

An educational intervention to improve the quality of care of diabetic patients

OBJECTIVE

As few studies have addressed intervention for in-hospital care of diabetes mellitus (DM) patients, we set out to investigate whether an educational intervention targeting doctors could improve the quality of care for diabetic patients.

DESIGN

An observational interventional study conducted at Pretoria Academic Hospital, a tertiary care hospital.

SUBJECTS

Doctors working in the Department of Internal Medicine were the subjects of two interventional sessions on diabetic care, and all diabetic patients admitted to the wards in the above Department were evaluated.

OUTCOME MEASURES

A Diabetes Attitude Scale (DAS-3) and a Diabetes Practice Scale (DPS) were completed by each doctor before and after the interventional educational sessions. Data from diabetic patients in the wards were collected for 5 weeks before and 5 weeks after the interventional training, and these two sets of data were compared to measure the effect of the interventional training.

RESULTS

Subscales of the DAS-3 showed an improvement, with a statistically significant improvement in attitude regarding seriousness of DM (P = 0.03), and a trend towards improvement in attitude regarding need for special training and patient autonomy. Most of the items on the DPS improved significantly (P < 0.05).

CONCLUSIONS

A short educational intervention resulted in an improvement in attitude, knowledge and clinical management of diabetic patients.

National policy on testing for HIV in South Africa: an urgent need

No National Policy exists in South Africa for the testing of persons who may be infected by HIV/AIDS. A Draft National Policy on Testing for HIV was published in the Government Gazette by the Minister of Health for commentary in December 1999. The policy provides for the following: circumstances under which HIV testing may be conducted; informed consent, pre-test and post-test counselling; and the interpretation of the policy. This policy will apply to persons who are able to give consent as well as to those who are legally entitled to give proxy consent to HIV testing. Testing with informed consent means that the individual has been made aware of, and understands, the implications of the test. "The vision which fueled our struggle for freedom; the deployment of energies and resources; the unity and commitment to common goals--all these are needed if we are to bring AIDS under control. Future generations will judge us on the adequacy of our response." President Nelson Mandela. DAVOS, 1996.

Further offences by discharged psychiatric patients--can somebody be held liable?

The decision to release a state patient who is unfit to stand trial and/or not criminally responsible, who had been committed to a mental institution in terms of the Criminal Procedure Act or who was held in terms of section 28 of the Mental Health Act, may have harmful or even fatal consequences. The multi-professional team at Oranje Hospital will only institute discharge procedures regulated in terms of section 29 of the Mental Health Act when it is of the opinion that a state patient's mental illness is stable and well-controlled and his clinical picture is such that he qualifies to be discharged. In this discussion focus will be placed on: a. the two discharge procedures applied in South Africa. b. four case studies which will be presented dealing with the observation period, admission, offence, diagnosis, treatment, hospitalisation, leave periods, discharge on certain conditions, re-admission and further offences. c. the question of whether the State may be held liable for the negligent or wrongful discharge or release of a state patient who subsequently commits a serious crime.

Criteria for fitness to stand criminal trial

OBJECTIVE

To identify criteria whereby triability can be determined.

DESIGN

Questionnaire survey. The final rating was decided on the basis of a structured psychiatric interview.

SETTING

Oranje Hospital, Bloemfonteln.

PARTICIPANTS

A total of 736 questionnaires was sent to 176 judges of the Supreme Court, 480 magistrates and 32 attorneys-general and state advocates in South Africa and Namibia, and 33 psychiatrists and 15 clinical psychologists working in forensic psychiatric units in South Africa. With the information from the completed questionnaires, rating criteria were compiled. The rating criteria were applied by means of a structured interview to 100 persons referred in terms of section 77(1) of the Criminal Procedure Act 51 of 1977. A multiprofessional psychiatric team was requested to evaluate the same 100 observandi independently.

RESULTS

A total of 298 (40.5%) of the questionnaires were returned. From the data of the completed questionnaires, 19 legal items, 17 psychiatric items, 2 special laboratory tests and 2 psychosocial items were identified as the most important and clear diagnostic indications for the evaluation of triability. The similarity between the findings of the researchers and those of the multiprofessional psychiatric team was meaningful to 1% of significance. For the proper application of the criteria a cut-off point of 31 was determined. A score of 31 or higher therefore indicates that a patient is unfit to stand trial, while a score of less than 31 indicates triability.

CONCLUSIONS

The application of the proposed final rating criteria as a single method of rating is at the very least just as reliable as the multiprofessional team in evaluating fitness to stand trial. The proposed criteria, used as a single rating instrument, are cost-effective in terms of time and staff, avoid unnecessary hospitalisation and ensure that mentally ill accused will have a fair trial.

Informed consent: research and the psychotic patient

During the past few decades, western societies seem to have placed a particularly high premium on the individual's personal integrity and right to self-determination. Presently, obtaining a patient's consent is accepted as a prerequisite for the performance of any form of medical treatment, whether diagnostic or therapeutic in nature. A study was undertaken in various centres involved with clinical trials to compare the procedures used for obtaining informed consent from a psychotic patient. Although the study did not investigate the legal aspects related to consent and informed consent, it is necessary that one must be aware of these aspects when doing clinical trials.

The protection of personal and medical data--a call for confidentiality

Personal data and privacy are increasingly being threatened by a boom in technological development--the replacement of conventional networks of communication with the perfected combination of computer and telecommunications. The subsequent high degree of transparency has the potential to damage the individual's right to 'informational self-determination'. The most common ways of unlawfully entering a computer data system, the reasons why an individual's information is treated as confidential and the ethical issues involved, international and local statutory instruments that protect such personal information, and ways to stop the outflow of personal information are discussed.

The creation and development of an instrument to determine fitness to stand trial

A research team, consisting of a jurist and a psychologist, created and developed an instrument which could be used to effectively assess the fitness to stand trial of an accused person. A questionnaire was compiled and sent out to 736 members of both the legal and mental health professions. The information received from the response group was used to compile the fitness instrument. This instrument was applied to 100 observandi, committed to Oranje Hospital in terms of the Criminal Procedure Act, by way of a semi-structured interview. The same 100 observandi were evaluated by a multi-disciplinary team of the hospital and the results of the two groups were compared. This comparison showed a significant resemblance and it was concluded that the instrument could successfully be used as a single method of evaluating triability.

Legal status of the mentally disabled person in South African law

Mental illness or insanity has a dramatic influence on a person's legal status. A person's status determines his or her competencies such as legal capacity, capacity to act, accountability and capacity to litigate. A mentally ill person is incapable of performing juristic acts; he or she is not capable of becoming a party to legal proceedings; is virtually incapable of committing a crime or being liable for a delict; etc. However, not all mentally ill persons are precluded from performing legal acts or, for that matter, giving valid consent to medical treatment. The reason being that status is factually determined according to the degree to which the mental illness is present at the time when the mentally ill person participates in the legal traffic. The measure of capability depends on the patient's intellectual and volitional capacities that will decide whether the patient can validly contract, litigate or consent to medical treatment. More specifically medical research of a non-therapeutic nature can only be carried out on mental patients who are capable of consenting thereto. This article endeavours to touch upon the different aspects of the mentally ill person's legal status.