With the recent approval of a South African (SA) National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western Cape, SA. Palliative care services in SA started in the non-governmental sector in the 1980s. The first SA hospital-based palliative care team was established in Charlotte Maxeke Johannesburg Academic Hospital in 2001. The awareness of the benefit of palliative care in the hospital setting led to the development of isolated pockets of excellence providing palliative care in the public health sector in SA. This article describes models for palliative care at tertiary, provincial and district hospital level, which could inform development of hospital-based palliative care as the national policy for palliative care is implemented in SA.

In this article, the focus is on the literary and hymnological aspects of Psalm 23. This psalm is analyzed in terms of all its linguistic nuances. A network of metaphors is woven around the motif of the shepherd in Psalm 23. This psalm can be divided into four stanzas which are arranged chiastically - verses 1b-3: confession/testimony (He-I), verse 4: a prayer of trust (I-You), verse 5: a prayer of trust (You-I) and verse 6: confession/testimony (I-He). The syntactic and semantic aspects of the Psalm are investigated, while poetic patterns are also considered. Some figures of speech, for instance, metaphors, are scrutinised. Especially the shepherd metaphor captures the attention. The title "shepherd" which is attributed to the ruling king, is often encountered in the court terminology of the Ancient Near East. In the prologue of the Codex of Hammurabi the king is described as a shepherd who is called by Enlil. This Codex mentions that the gods installed the king's office as shepherd and that they visited him. The motif of shepherd frequently appears in the Old Testament. However, the title "shepherd" is not conferred on the ruling king as was the case in Egypt and Mesopotamia. This title is sometimes ascribed to David (2 Samuel 5:2; 7:7; 24:17), however, it is often used when leaders are accused of neglecting their duties (Ezekiel 34:4 foll.). The metaphor of the host is also illuminated. Yahweh is emphasized as a host. Yahweh is the subject of the verbs in these verses. The result is that Yahweh's deeds are emphasized. The expression "Yahweh prepares a table before me" refers to the fact that Yahweh presents his hospitality to the psalmist. The meal is the proof of Yahweh's protecting and caring nature. Also the literary genre of the psalm is investigated. The psalm is not only a psalm of trust or only one of thanksgiving, because features of both these Gattungen are displayed. The text of Psalm 23 gives us comfort. The psalmist's experiences of comfort, protection and support are expressed. One of the functions of the psalm is to encourage the reader/hearer in difficult times. Thus the psalm is also a psalm of trust. Attention is furthermore paid to the reception history of the psalm. In this regard, the interpretation of Psalm 23 is traced in the New Testament and in the history of the church. This investigation is necessary, since one relies on one's understanding of the original text when versifying poetry. The Messianic interpretation of Psalm 23 has an important bearing on the liturgy of baptism and the service of Eucharist. During the fourth and fifth centuries and especially in the catechesis of baptism, every verse of Psalm 23 was connected to Christ and to those who met Christ through baptism. The "green pastures" were the supportive words of the Holy Scriptures as embodied by the catechesis of baptism. The "quiet waters" indicated the water with which someone was bapitised. The "paths of righteousness" evoked associations with catechesis of baptism; more specifically the ethical principles of behaviour which were connected to these catechesis. T T Cloete has versified all 150 Psalms for the "Liedboek van die Kerk" (Hymn book of the Church). Cloete's versification of the psalms is based on the interpretation and understanding of the Hebrew text. All the fabrics of the text are followed and versified in Afrikaans. The versification of a text poses its own challenges. These pertain to matters like rhyme patterns, metaphors, the contemporary nature of the versification and the musical requirements (such as, for example, the word/tone relationship) which hang like a sword above the text. Anyone who dares to versify poetry has to be himself a poet of high quality. Cloete is more than qualified for this task. In this article, his versified poem is analyzed on the level of structure and language. The poetical quality of his work is also considered. Furthermore, the musicological demand of Psalm 23 as a song is taken into consideration. The hand of the poet is restricted by musicological demands. These influence the rhyming words, the syntax, the word order, and even the appropriation of metaphors. The conclusion reached in this article is that Cloete's versification of Psalm 23 is outstanding indeed. He succeeds splendidly in giving the psalm a theological voice which resounds, as a song, in both mouth and heart.

In hierdie artikel word daar gefokus op die literêre en himnologiese aspekte van Psalm 23. Hierdie psalm word in al sy taalgeledinge ontleed. Die sintaktiese en semantiese fasette van die psalm word ondersoek. Daar word gelet op poëtiese patrone. Sekere stylfigure, soos metafore, word ondersoek. Daar word ook aandag gegee aan die resepsiegeskiedenis van die psalm. In dié opsig word die interpretasie daarvan in die Nuwe Testament en in die kerkgeskiedenis nagegaan. Hierdie ondersoek is noodsaaklik omdat die omdigting van 'n psalm op die verstaan van die grondteks berus. T T Cloete het al 150 psalms vir die Liedboek van die Kerk omdig. 'n Omdigter moet self 'n digter van hoë kwaliteit wees om sy hand aan omdigtings te waag. Cloete voldoen by uitnemendheid aan dié vereiste. In die artikel word sy omdigting op struktuur- en taalvlak ontleed. Daar word ook na die poëtiese gehalte daarvan gekyk. Verder word die musikologiese eise wat die lied stel ook in ag geneem. Die gevolgtrekking waartoe daar in die artikel gekom word, is dat die omdigting van Cloete voortreflik is. Hy slaag uitmuntend daarin om aan die lied 'n teologiese stem te gee wat singend in harte en monde weerklink.

OBJECTIVE Using burden of disease methodology, estimate the health risks of intimate partner violence (IPV) among women in Victoria, Australia. METHODS We calculated population attributable fractions (from survey data on the prevalence of IPV and the relative risks of associated health problems in Australia) and determined health outcomes by applying them to disability-adjusted life year estimates for the relevant disease and injury categories for Victoria, Australia for 2001. FINDINGS For women of all ages IPV accounted for 2.9% (95% uncertainty interval 2.4-3.4%) of the total disease and injury burden. Among women 18-44 years of age, IPV was associated with 7.9% (95% uncertainty interval 6.4-9.5%) of the overall disease burden and was a larger risk to health than risk factors traditionally included in burden of disease studies, such as raised blood pressure, tobacco use and increased body weight. Poor mental health contributed 73% and substance abuse 22% to the disease burden attributed to IPV. CONCLUSION Our findings suggest that IPV constitutes a significant risk to women's health. Mental health policy-makers and health workers treating common mental health problems need to be aware that IPV is an important risk factor. Future research should concentrate on evaluating effective interventions to prevent women being exposed to violence, and identifying the most appropriate mental health care for victims to reduce short- and long-term disability.

OBJETIVO Estimar los riesgos que supone para la salud de las mujeres del estado de Victoria (Australia) la violencia de la pareja (VP), utilizando para ello la metodología de la carga de morbilidad. MÉTODOS A partir de los datos de encuestas realizadas en Australia sobre la prevalencia de la VP y los riesgos relativos de los problemas de salud conexos, calculamos las fracciones poblacionales atribuibles y determinamos los resultados sanitarios, aplicándolos a las estimaciones de los años de vida ajustados en función de la discapacidad que se perdieron en Victoria, en el año 2001, por las enfermedades y lesiones pertinentes. RESULTADOS En las mujeres de todos los grupos de edad, la VP fue responsable de un 2,9% (intervalo de incertidumbre del 95%: 2,4 a 3,4%) de la carga total de enfermedad y lesiones. En las mujeres de 18 a 44 años, la VP se asoció al 7,9% (intervalo de incertidumbre del 95%: 6,4 a 9,5%) de la carga general de morbilidad, y representó para la salud un riesgo más importante que los factores de riesgo incluidos tradicionalmente en los estudios sobre la carga de morbilidad, tales como la hipertensión arterial, el consumo de tabaco y el peso corporal excesivo. Los problemas de salud mental representaron un 73% de la carga de morbilidad atribuida a la VP, y el abuso de sustancias psicotrópicas el 22%. CONCLUSIONES Los datos obtenidos indican que la VP supone un riesgo importante para la salud de la mujer. Los planificadores de las políticas de salud mental y los profesionales sanitarios que atienden los problemas de salud mental comunes deben tomar conciencia de que la VP es un factor de riesgo importante. Las investigaciones futuras deberían centrarse en la evaluación de intervenciones eficaces que eviten la exposición de las mujeres a la violencia y en la identificación de los cuidados de salud mental más apropiados para reducir la discapacidad de las víctimas a corto y a largo plazo.

OBJECTIF Estimer les risques pour la santé de la violence du partenaire sexuel chez les femmes de l'Etat de Victoria en utilisant la méthodologie de la charge de morbidité. MÉTHODES L'étude a consisté à calculer les fractions attribuables dans la population (à partir de données d'enquête sur la prévalence de cette forme de violence et les risques relatifs de problèmes de santé qui lui sont associés en Australie) et à déterminer les issues sanitaires en les appliquant aux estimations des années de vie perdues ajustées sur l’incapacité pour les catégories pertinentes de maladies et de traumatismes, dans l'Etat de Victoria (Australie), en 2001. RÉSULTATS Chez les femmes de tous âges, la violence du partenaire sexuel est à l'origine de 2,9 % (intervalle d'incertitude à 95 % : 2,4-3,4 %) de la charge totale de morbidité et de traumatismes. Chez les femmes âgées de 18 à 44 ans, la violence du partenaire sexuel est associée à 7,9 % (intervalle d'incertitude à 95 % : 6,4-9,5 %) de la charge de morbidité globale et constitue un risque plus important pour la santé que les facteurs de risque traditionnellement observés dans les études sur la charge de morbidité tels que l'hypertension, le tabagisme et l’excès pondéral. La charge de morbidité attribuée à la violence du partenaire sexuel est due pour 73 % à des problèmes de santé mentale et à 22 % à l'abus de tabac, d’alcool ou de substances illicites. CONCLUSION Les résultats montrent que la violence du partenaire sexuel constitue un risque important pour la santé de la femme. Les responsables de la politique de santé mentale et les agents de santé appelés à soigner les problèmes de santé mentale courants doivent être conscients de l'importance que constitue cette forme de violence en tant que facteur de risque. De nouveaux travaux de recherche devraient porter sur l'évaluation d'interventions efficaces pour éviter que les femmes soient exposées à la violence et sur la détermination des soins de santé mentale les plus appropriés pour les victimes afin de réduire l'incapacité à court et à long terme.