The education reform efforts in Botswana have focused predominantly on teacher preparation, recruitment and compensation. Recruitment efforts have resulted in a significant number of expatriates working with indigenous teachers in many schools. However, as the schools are currently upgraded and restructured, the quality of the working relationships forged between indigenous and expatriate teachers represents one vital aspect in the reform effort that has gone almost unattended. Many teachers have become dissatisfied and concerned about these relationships, despite compensation and preparation. A decisive first step in attending to these relationships lies in understanding how they develop. The aim of this exploratory study was to identify and describe factors related to the development of working relationships between indigenous and expatriate teachers and illustrate how those factors contribute to the development of these relationships. The study employed a micropolitical perspective and through phenomenological interviews, observation and document analysis, indicated that cultural differences in language and communication, regard for time, handling of student discipline, work ethics and professionalism along with ambiguity and uncertainty, professional and interpersonal obligations, indigenous to expatriate teacher ratio and the interplay of micropolitics are related to the development of these relationships. Results, however, are specific to one school context and should not be generalized. The study recommends management strategies such as provision of programmes for cultural exchange, communication mode standardization, a dean of discipline system, faculty building and further research to redress the situation. / Further Teacher Education / M.Ed.

This study is comprised of two parts: an unauthorised biography of the South African musician David Kramer, as well as a reflective look at the process of writing this biography. In this regard the following aspects were looked at closely: finding an appropriate style, biography versus propaganda, conjecturing, the bilingual nature of the text, problems of research, ethics, influences, make-believe, approach to the subject, intertextuality, and fictionalisation. The central question of the biography is to highlight the success of a fellow Worcester (the author’s hometown) boy. The central research questions of the thesis are the fictionalisation of the nonfiction text, intertextuality, and the question of a text written in both English and Afrikaans. With regard to the aforementioned fictionalisation, a biographical text is classified as “nonfiction”, because it deals with a real person and real events. However, a text such as David Kramer – an unauthorised biography presents an alternative perspective, in that the narrative often moves into fiction, or “creative nonfiction”. Written texts are traditionally divided into two fields: fiction or nonfiction. Nonfiction is deemed to be fact, truth, whereas fiction is the fruit of an author’s imagination. But perhaps the notion of truth versus untruth is too limited, and one should include the words “objectivity” and “subjectivity”. Some texts incorporate both elements, be they newspaper editorials which are mostly opinion, advertisements which are highly subjective, or biographies such as Taraborrelli’s Madonna – An Intimate Biography, which often reads as a novel. This doctoral thesis looks at David Kramer – an unauthorised biography, which is at times “faction”, to illuminate the sections where the text fell somewhere between fiction or nonfiction. In attempting this exercise, intertextuality was useful in two ways. Firstly, to ground the text in a reality the reader could believe, as it brought “real” things to the text, such as song lyrics, photographs, et cetera, all things which brought some credibility to the truth of the text, and secondly to place the events being described in a certain timeframe. The use of English and Afrikaans in the biography was to reflect that Kramer uses both languages in his songs, and furthermore, to give an idea of the South Africa at the time of Kramer’s early success: the divides of English/Afrikaans, white/black, liberal/conservative. / Thesis (PhD)--University of Pretoria, 2011. / Unit for Creative Writing / Unrestricted

Cette thèse est basée sur ma contribution à différents projets liés à la recherche clinique sur les anévrismes intracrâniens, le traitement endovasculaire, la compréhension des patients et la participation aux essais cliniques. Ce travail a donné lieu à quatre publications à ce jour. Pour cette thèse, je fournis d'abord quelques informations sur les anévrismes cérébraux et la façon dont ils sont gérés. Deuxièmement, je passerai brièvement en revue les principes de l'éthique médicale et de la recherche. J'aborde ensuite l'essai de soins ‘Comprehensive Aneurysm Management (CAM)’, car une partie du travail effectué pour ma thèse consistait à rendre compte des taux de recrutement dans CAM. J'ai également contribué à un article sur la démarcation recherche-soins, et pourquoi elle doit être révisée, ainsi qu'à un éditorial qui affirme que la recherche clinique doit être conçue dans le meilleur intérêt des patients. Enfin, j'ai apporté des contributions originales en concevant une enquête et en interrogeant des patients neurovasculaires avant qu'ils ne soient vus par un médecin dans le cadre d'un suivi. Les résultats de cette étude ont montré que les patients ont une meilleure compréhension de l'incertitude clinique et de l'existence d'options alternatives de prise en charge lorsqu'ils ont participé à des essais de soins. / This thesis is based on my contribution to different projects related to clinical research on intracranial aneurysms, endovascular treatment, patient understanding and participation in clinical trials. This work has led to four publications thus far. For this thesis, I first provide some background on cerebral aneurysms and how they are managed. Second, I briefly review medical and research ethics principles. I then discuss the Comprehensive Aneurysm Management (CAM) care trial because a portion of the work done for my thesis was to report on the recruitment rates in CAM. I also contributed to a paper on the research-care demarcation and why it must be revised, as well as to an editorial claiming that clinical research should be designed in patients' best interests. Finally, I made original contributions by designing a survey and interviewing neurovascular patients prior to being seen by a physician in follow-up. The results of that study showed that patients have a better understanding of clinical uncertainty and the existence of alternative management options when participating in care trials.

La littérature abordant les enjeux socio-éthiques et réglementaires associés aux médicaments est relativement abondante, ce qui n’est pas le cas des dispositifs médicaux (DM). Ce dernier secteur couvre une très large diversité de produits qui servent à de multiples applications: diagnostic, traitement, gestion des symptômes de certaines conditions physiques ou psychiatriques, restauration d’une fonction débilitante, chirurgie, etc. À tort, on a tendance à croire que les DM sont réglementés de la même manière que les médicaments, que ce soit pour les exigences concernant leur mise en marché ou des pratiques de surveillance après mise en marché. Or, au cours des dernières années, leur usage élargi, leur impact sur les coûts des soins de santé, et les rappels majeurs dont certains ont fait l’objet ont commencé à inquiéter la communauté médicale et de nombreux chercheurs. Ils interpellent les autorités réglementaires à exercer une plus grande vigilance tant au niveau de l’évaluation des nouveaux DM à risque élevé avant leur mise en marché, que dans les pratiques de surveillance après mise en marché. Une stratégie plus rigoureuse d’évaluation des nouveaux DM permettrait d’assurer un meilleur suivi des risques associés à leur utilisation, de saisir la portée des divers enjeux socio-éthiques découlant de l’utilisation de certains DM, et de préserver la confiance du public. D’emblée, il faut savoir que les autorités nationales n’ont pas pour mandat d’évaluer la portée des enjeux socio-éthiques, ou encore les coûts des DM qui font l’objet d’une demande de mise en marché. Cette évaluation est essentiellement basée sur une analyse des rapports risques-bénéfices générés par l’usage du DM pour une indication donnée. L’évaluation des impacts socio-éthiques et l’analyse coûts-bénéfices relèvent des agences d’Évaluation des technologies de santé (ÉTS). Notre recherche montre que les DM sont non seulement peu fréquemment évalués par les agences d’ÉTS, mais l’examen des enjeux socio-éthiques est trop souvent encore incomplet. En fait, les recommandations des rapports d’ÉTS sont surtout fondées sur une analyse coûts-bénéfices. Or, le secteur des DM à risque élevé est particulièrement problématique. Plusieurs sont non seulement porteurs de risques pour les patients, mais leur utilisation élargie comporte des impacts importants pour les systèmes de santé. Nous croyons que le Principisme, au cœur de l’éthique biomédicale, que ce soit au plan de l’éthique de la recherche que de l’éthique clinique, constitue un outil pour faciliter la reconnaissance et l’examen, particulièrement par les agences d’ÉTS, des enjeux socio-éthiques en jeu au niveau des DM à risque élevé. Également, le Principe de Précaution pourrait aussi servir d’outil, particulièrement au sein des agences nationales de réglementation, pour mieux cerner, reconnaître, analyser et gérer les risques associés à l’évaluation et l’utilisation de ce type de DM. Le Principisme et le Principe de Précaution pourraient servir de repères 1) pour définir les mesures nécessaires pour éliminer les lacunes observées dans pratiques associées aux processus de réglementation, et 2) pour mieux cerner et documenter les enjeux socio-éthiques spécifiques aux DM à risque élevé. / Socio-ethical and regulatory issues about drug development have received substantial coverage in the scientific literature over the years; this has not been the case of medical devices (MD). This latter sector comprises a vast array of products with a multitude of applications: diagnostics, treatment, symptom management for severe physical and psychiatric conditions, restoring physical functioning, surgery, etc. There is a mistaken view that MD are regulated in the same manner as pharmaceutical drugs, whether this be requirements regarding premarket assessment or post-market surveillance. Not only has the extensive use of MD in clinical practice and the resulting impact on healthcare expenditures raised concerns in the scientific and medical communities, but so too have the many recalls for high risk devices in recent years. Regulatory authorities have been challenged to exercise greater vigilance in both the premarket assessment and post-market surveillance of new high risk MD. A more rigorous evaluation strategy for new MD would permit better monitoring of the risks associated with their use, better understanding of the significance of the various socio-ethical issues arising from the use of MD, and thus preserve public confidence. From the outset, it should be noted that national authorities do not have a mandate to assess the significance of socio-ethical issues or the costs associated with the MD that are the subject of an application for marketing approval. This assessment is based primarily on risk-benefit analysis reports generated following the use of MD for a given indication. Evaluation of socioethical impact and cost-benefit analysis are the remit of Health Technology Assessment (HTA) agencies. But research shows that the MD are not only infrequently assessed by HTA agencies, but the consideration of socio-ethical issues is often incomplete; the recommendations of HTA reports are based mostly on a calculation of cost-benefit. However, the high risk MD sector is particularly problematic; many carry risks not only for patients, but their extended use has significant impact on healthcare systems. I argue that Principlism, associated to biomedical ethics, as much to research ethics and clinical ethics, could be adapted to facilitate the recognition and evaluation by HTA agencies of socio-ethical issues involved in high risk MD. The Precautionary Principle could also serve as a tool to help regulatory agencies to enforce understanding, recognition, analysis and management of the risks associated with the use of MD, especially high risk devices. Principlism and the Precautionary Principle could serve as benchmarks to 1) define necessary steps to eliminate gaps observed in the regulatory process, and 2) better understand and document the socio-ethical issues specific to high risk MD.

Platonic Craft and Medical Ethics examines the Platonic theory of craft and shows its application to different ethical problems in medicine, both ancient and modern. I begin by elucidating the Platonic use of the term “craft” or “technē”, using especially the paradigmatic craft of medicine, and explicate a number of important principles inherent in his use of the term. I then show how Plato’s framework of crafts can be applied to two ancient debates. First, I show how Plato’s understanding of crafts is used in discussing the definition of medicine, and how he deals with the issue of “bivalence”, that medicine seems to be capable of generating disease as well as curing it. I follow this discussion into Aristotle, who, though he has a different interpretation of bivalence, has a solution in many ways similar to Plato’s. Second, I discuss the relevance of knowledge to persuasion and freedom. Rhetors like Gorgias challenge the traditional connections of persuasion to freedom and force to slavery by characterizing persuasion as a type of force. Plato addresses this be dividing persuasion between sorcerous and didactic persuasion, and sets knowledge as the new criterion for freedom. Finally, I discuss three modern issues in medical ethics using a Platonic understanding of crafts: paternalism, conclusions in meta-analyses and therapeutic misconceptions in research ethics. In discussing paternalism, I argue that tools with multiple excellences, like the body, should not be evaluated independently of the uses to which the patient intends to put them. In discussing meta-analyses, I show how the division of crafts into goal-oriented and causal parts in the Phaedrus exposes the confusion inherent in saying that practical conclusions can follow directly from statistical results. Finally, I argue that authors like Franklin G. Miller and Howard Brody fail to recognize the hierarchical relationship between medical research and medicine when they argue that medical research ethics should be autonomous from medical ethics per se.

Platonic Craft and Medical Ethics examines the Platonic theory of craft and shows its application to different ethical problems in medicine, both ancient and modern. I begin by elucidating the Platonic use of the term “craft” or “technē”, using especially the paradigmatic craft of medicine, and explicate a number of important principles inherent in his use of the term. I then show how Plato’s framework of crafts can be applied to two ancient debates. First, I show how Plato’s understanding of crafts is used in discussing the definition of medicine, and how he deals with the issue of “bivalence”, that medicine seems to be capable of generating disease as well as curing it. I follow this discussion into Aristotle, who, though he has a different interpretation of bivalence, has a solution in many ways similar to Plato’s. Second, I discuss the relevance of knowledge to persuasion and freedom. Rhetors like Gorgias challenge the traditional connections of persuasion to freedom and force to slavery by characterizing persuasion as a type of force. Plato addresses this be dividing persuasion between sorcerous and didactic persuasion, and sets knowledge as the new criterion for freedom. Finally, I discuss three modern issues in medical ethics using a Platonic understanding of crafts: paternalism, conclusions in meta-analyses and therapeutic misconceptions in research ethics. In discussing paternalism, I argue that tools with multiple excellences, like the body, should not be evaluated independently of the uses to which the patient intends to put them. In discussing meta-analyses, I show how the division of crafts into goal-oriented and causal parts in the Phaedrus exposes the confusion inherent in saying that practical conclusions can follow directly from statistical results. Finally, I argue that authors like Franklin G. Miller and Howard Brody fail to recognize the hierarchical relationship between medical research and medicine when they argue that medical research ethics should be autonomous from medical ethics per se.

No description available.

This study explored academic researchers’ engagement in research ethics at an OpenDistance Learning (ODL) institution in South Africa (SA), with the intention of discovering the way in which human resource management (HRM) practitioners, employed at the same institution, can support academic researchers’ engagement in research ethics. The study’s purpose was to develop a conceptual framework for HRM practitioners to support academic researchers’ engagement in research ethics, at an ODL institution in SA.For this qualitative study, an Interpretative Phenomenological Analysis (IPA) approach was followed. Data were collected from 13 purposively selected academic researchers, employed at an ODL institution, by means of semi-structured individual interviews, naive sketches and fieldnotes. The IPA approach offers an analysis method that was accordingly employed. Thereafter, the findings were interpreted with the Job-Demands Resource (JD-R) theory.These interpretations were used to construct the conceptual framework according to the organising principles of Dickhoff, James and Wiedenbach (1968) Academic researchers have some resources to support engagement in research ethics, but also face several job demands, which has a negative influence on their ability to engage in research ethics. HRM practitioners have a critical role to fulfil to support academic researchers’ engagement in research ethics, by facilitating a work environment where job resources are readily available. In addition, the ODL institution must be well-balanced, successful, and endorse a culture of ethics within its organisational culture, for academic researchers to engage in research ethics. HRM practitioners have an essential role to endorse a culture of ethics within the ODL institution. The findings will benefit both academic researchers and the ODL institution. The support that HRM practitioners provide, should include, inter alia, a) enabling an engaging leadership style, b) ensuring that ethical values are embedded in the recruitment strategy, and c) revising the performance agreements and performance appraisals of academic employees to include research ethics. This study forms part of a limited pool of qualitative studies to investigate WE, using the JD-R theory as a theoretical framework. This study is furthermore a forerunner in exploring the role that HRM practitioners can play in supporting academic researchers’ engagement in research ethics. It is the first study to use the IPA approach in the field of Management Sciences to investigate WE with the JD-R theory as a theory of engagement. By using the organising principles of Dickoff et al. (1968), for conceptual framework development to explain WE according to the JD-R theory, a seminal contribution was made. / Hierdie studie ondersoek akademiese navorsers se verbintenis tot navorsingsetiek by ’n oopafstandleerinstelling (ODL institution) in Suid-Afrika met die voorneme om ’n manier te vind waarop nslikehulpbronbestuurspraktisyns (MHB-praktisyns) wat by dieselfde instelling werksaam is, akademiese navorsers se verbintenis tot navorsingsetiek kan ondersteun. Die studie se oogmerk was om ’n konseptuele raamwerk vir MHB-praktisyns te ontwikkel om akademiese navorsers se verbintenis tot navorsingsetiek by ’n pafstandleerinstelling te ondersteun. Vir hierdie kwalitatiewe studie is ’n Interpreterende Fenomenologiese Ontledingsbenadering (Interpretative Phenomenological Analysis [IPA] approach) gevolg. Data is by 13 doelbewusgeselekteerde akademiese navorsers, werksaam by ’n oopafstandleerinstelling, ingesamel deur middel van migestruktureerde- individuele onderhoude, naïewe sketse en veldnotas. Die Interpreterende Fenomenologiese Ontledingsbenadering bied ’n ntledingsmetode wat dienooreenkomstig gebruik is. Hierna is die bevindings met die werk- vereistes-hulpbronneteorie (job-demands resource [JD-R] theory) geïnterpreteer. Hierdie interpretasies is gebruik om die konseptuele raamwerk te ontwikkel volgens die organiseringsbeginsels van Dickhoff, James en Wiedenbach (1968). Akademiese navorsers beskik oor ’n paar hulpbronne wat ’n verbintenis tot navorsingsetiek ondersteun, maar word ook met verskeie werkseise gekonfronteer wat ’n negatiewe invloed op hulle vermoë om hul tot navorsingsetiek te verbind, kan hê. MHB-praktisyns speel ’n kritiese rol om akademiese navorsers te ondersteun ten opsigte van hul verbintenis tot navorsingsetiek deur ’n werksomgewing te fasiliteer waar werkshulpbronne geredelik beskikbaar is. Verder moet die oopafstandleerinstelling ‘n gebalanseerde etiese organisasiekultuur onderskryf om akademiese navorsers te help om hulle te verbind tot etiese navorsing. MHB-praktisyns speel ’n noodsaaklike rol om ’n etiese kultuur binne die ODL- instelling te ondersteun. Akademiese navorsers, sowel as die oopafstandleerinstelling, sal baat vind by die bevindinge. Die ondersteuning wat MHB-praktisyns bied, behoort onder meer die volgende in te sluit: a) om ’n werksbegeesterde leierskapstyl moontlik te maak; b) om te verseker dat etiese waardes by die werwingstrategie ingesluit is; en c) om die prestasie-ooreenkomste en prestasiebeoordelings van akademiese personeel te hersien om navorsingsetiek in te sluit. / Lolu cwaningo lwacubungula ukulandela nokusebenzisa kwabacwaningi inkambiso yocwaningo enhle nelungileyo esikhungweni seMfundo-buqama Evulelekile (ODL), phecelezi, i-Open Distance Learning institution eNingizimu Afrika (SA), ngenhloso yokuthola indlela engasetshenziswa ngabasebenzi abangongoti bezokuphathwa kwabasebenzi (HRM), abaqashwe esikhungweni leso, ukweseka ukulandela nokusebenzisa kwabacwaningi bezikhungo zemfundo ephakeme inkambiso yocwaningo enhle nelungileyo uma benza ucwaningo. Inhloso yalolu cwaningo kwabe kuwukwakha okuthuthukisa uhlaka-kuhlaziya lokuqonda olwenzelwe abasebenzi be-HRM ekusekeleni abacwaningi bezikhungo zemfundo ephakeme ukuze bakwazi ukulandela nokusebenzisa inkambiso enhle nelungileyo uma benza ucwaningo esikhungweni esiyi-ODL eNingizimu Afrika. Kulolu cwaningo olwabe luwucwaningo olugxile ekuxoxisaneni okunzulu futhi okunohlonze nababambiqhaza bocwaningo bakhethiweyo abayingcosana (qualitative research) kwalandelwa indlela-kuhlaziya egxile kwisimo-kuqonda sombambiqhaza ocwaningo, phecelezi i-Interpretative Phenomenological Analysis (IPA). Imininingo yocwaningo yaqoqwa kubacwaningi bezikhungo zemfundo ephakeme abayi-13 abakhethwe ngenhloso, kusetshenziswa indlela-kuxoxisana engagcini nje kuphela ohlwini lwemibuzo ehlelekile, kepha elandelisa nangeminye imibuzo evulekile, phecelezi ama-semi-structured individual interviews, nemidwebo elula kanye namanothi athathwe endaweni okwenzelwa kuyona ucwaningo. Indlela-kuhlaziya i-IPA ihlinzeka ngendlela yokuhlaziya okuyiyona eyasetshenziswa ocwaningweni. Emuva kwalokho imiphumela eyatholakala ocwaningweni yahunyushwa kusetshenziswa ithiyori i-Job-Demands Resource (JD-R) theory. Ngokusho kuka-Dickhoff, James no-Wiedenbach (1968) lezi zihumusho zabe sezisetshenziselwa ukwakha uhlaka-kuhlaziya lokuqonda. Abacwaningi bezikhungo zemfundo ephakeme banazo izinsiza-kusebenza zokulandela nokusebenzisa inkambiso yocwaningo enhle nelungileyo, kodwa-ke zikhona futhi nezingcindezi-zidingo zomsebenzi eziningana ezinomthelela ongemuhle emandleni abo okulandela nokusebenzisa inkambiso enhle nelungileyo uma benza ucwaningo. Abasebenzi be-HRM banendima esemqoka kakhulu okumele bayidlale ekwesekeni abacwaningi bezikhungo zemfundo ephakeme ekulandeleni nokusebenzisa inkambiso enhle nelungileyo uma benza ucwaningo, ngokuthi bakhe isimo sokusebenzela lapho ziyinala futhi zitholakala kalula izinsiza-kusebenza. Ngaphezu kwalokho isikhungo esiyi-ODL kumele kube ngesizinzile nesihleleke kahle, esiphumelelayo futhi eseseka usiko-mpilo lwenkambiso enhle nelungileyo ngaphakathi kusiko-mpilo lwaso njengenhlangano, ukuze abacwaningi bezikhungo zemfundo ephakeme bakwazi ukulandela nokusebenzisa inkambiso enhle nelungileyo uma benza ucwaningo. Abasebenzi be-HRM banendima esemqoka okumele bayidlale ekwesekeni usikompilo lwenkambiso enhle nelungileyo ngaphakathi esikhungweni esiyi-ODL. Imiphumela etholakale ocwaningweni izohlomulila abacwaningi bezikhungo zemfundo ephakeme iphinde futhi ihlomulise nezikhungo eziyi-ODL. Ukwesekwa okuhlinzekwa ngabasebenzi be-HRM kumele kubandakanye, phakathi kokunye, a) ukwakhiwa kwesitayela sobuholi senzebenziswano, ubambiswano nokubonisana b) kuqinisekisa ukuthi izimo-mpilo zenkambiso enhle nelungileyo ziyisisekelo seqhingasu lokuqashwa kwabasebenzi, kanye c) nokubuyekezwa kwezivumelwano zensebenzo kanye nokuhlolwa nokubuyekezwa komsebenzi wabasebenzi bezikhungo zemfundo ephakeme ukuze kubandakanywe inkambiso enhle nelungileyo. Lolu cwaningo luyingxenye yeqoqwana elincane lomsebenzi osuwenziwe kuze kube manje wocwaningo olugxile ekuxoxisaneni okunzulu futhi okunohlonze nababambiqhaza bocwaningo abakhethiweyo abayingcosana okuhloswe ngalo ukuphenya nokucwaninga i-WE, kusetshenziswa ithiyori i-JD-R njengohlaka lwethiyori yocwaningo. Ngaphezu kwalokho, lolu cwaningo luyivulandlela ekucubunguleni indima engadlalwa ngabasebenzi be-HRM ekwesekeni ukulandela nokusebenzisa kwabacwaningi bezikhungo zemfundo ephakeme inkambiso enhle nelungileyo uma benza ucwaningo. Lolu wucwaningo lokuqala olusebenzisa indlela-kuhlaziya i-IPA emkhakheni wamaSayensi Ezokuphatha ngenhloso yokuphenya nokuhlola i-WE kusetshenziswa ithiyori i-JD-R njengethiyori yokucubungula umsebenzi wocwaningo. Kwaba negalelo elikhulukazi impela ukusetshenziswa kwemigomo yokuhlela ka- Dickoff nabanye (1968), ekwakheni nokuthuthukisa uhlaka-kuhlaziya lokuqonda ngenhloso yokuchaza i-WE ngokuhambisana nethiyori i-JD-R / Human Resource Management / D. Phil. (Human Resource Management)