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Background: This paper describes findings from research conducted on students who participated in a service-learning course in South Africa. Objective: The study aimed to understand how participants constructed their experiences of service-learning and to interrogate their emotional investments in these constructions. Method: Data were collected and analyzed using a psychosocial methodology, consisting of discursive and psychoanalytic readings of interview transcripts, reflective journal entries, and researcher field notes. Results: The discursive findings focus on how participants employed liberal traditional learning discourses to construct service-learning as linear resulting in subject positions that reinforced prejudices and the power structures supporting these. A psychoanalytic reading of the data suggests that participants invested in these constructions to defend against their own anxiety related to uncertainty and guilt about privilege in an unfamiliar context. Conclusion: Students invest in liberal traditional discourses of service-learning for defensive reasons, which can be understood as arising from the intersubjective and social context in which the service-learning takes place. Teaching Implications: Recognizing prejudice as emanating from anxiety generated by the affective work required for service-learning means thinking creatively about how to both contain and allow this affective work to take place in service-learning activities. [ABSTRACT FROM AUTHOR]

There is a critical need for sex, sexuality and relationships education to be LGBTQI inclusive. Numerous studies, internationally and in South Africa, highlight this need but what constitutes an inclusive curriculum has not been sufficiently addressed. This paper seeks to advance this conversation by imagining a curriculum beyond compulsory heterosexuality and considers what knowledges and practices are necessary for the South African context. To do this, the authors consider the corpus of research about how sexualities are characterized in schooling generally and in the teaching of sexuality education specifically. Using the theoretical tools offered by Freire and hooks on critical consciousness, three arguments are made. First, the authors argue for the theoretical and empirical contributions of the sociology of gender and sexualities which are social constructions informed by history, social relations and power. Second, there is a need for a curriculum to recognize the intersectionality of learners and how identity knowledges shape the way that youth sexualities are understood and experienced. Finally, the teaching and learning of an LGBTQI inclusive curriculum will steer away from moralistic and didactic instruction in favor of more participatory pedagogies that acknowledge young people as agents and legitimate sexual beings. [ABSTRACT FROM AUTHOR]

Within the framework of the current drive to transform psychology in South Africa, this paper highlights "other" axes of identity that are arguably largely overlooked within the field. The conversation exposes the discipline of psychology – specifically within the South African context – and its many unexamined assumptions concerning "expected" identities of psychologists – specifically, those along heterosexual and able-bodied lines. By engaging in an autoethnographic conversation, the two authors, both "other", practising psychologists – one queer, one disabled – share and reflect on some of their experiences of feeling othered in their chosen profession. Drawing on parts of queer theory, critical disability literature, as well as the theoretical framework of biopolitical power, we start to make sense of our experiences of difference, deviance, and defiance. How the field of psychology marginalises "other" psychologists, and the impacts on those who bear the oppressions, is exposed; and a conversation is begun in which the discipline's assumptions around compulsory forms of identity – straight, not disabled, among others – are disrupted in productive ways. [ABSTRACT FROM AUTHOR]

Adolescents and youth with disabilities in South Africa still lack access to sexual and reproductive health and rights services including comprehensive sexuality education, which may increase their vulnerability to SRHR issues such as HIV and sexual violence. This is exacerbated for learners with intellectual disabilities whose educators often lack skills and tools to accommodate these learners in comprehensive sexuality education lessons. The following paper outlines the findings of a formative evaluation of an innovative sexuality training approach for educators of learners with diverse disabilities (Breaking the Silence approach). This approach was developed and piloted with educators across eight schools for learners with intellectual disabilities in KwaZulu-Natal, South Africa. The paper discusses the educators’ understanding and experiences of using this approach. The findings revealed that although educators were able to implement parts of the approach, contextual factors impacted the degree of implementation. These factors were related to perceptions of socio-cultural norms, interpersonal engagement with peers and management, the structural environment of school settings, and the wider community setting. Educators began to address cultural taboos related to talking about sexuality, but were challenged by untrained staff and the larger socio-cultural context, which includes a heighted risk of sexual violence against their learners. The paper concludes with recommendations for a further investigation of the approach within a whole school setting considering the needs of educators to not only acquire skills and knowledge but also to address their larger socio-cultural context in which they have to implement comprehensive sexuality education. [ABSTRACT FROM AUTHOR]

This paper challenges the view that, in the context of the HIV/AIDS pandemic, the African extended family is no longer able to care for and support orphaned children. The paper is based on a qualitative case study conducted in a South African urban area on the lived experiences of orphaned children aged 9–14. Data were collected from the children, their teachers as well as their main caregivers. The study found that, despite the poverty facing the extended family, emotional support, family cohesion and support for learning can serve to meet the educational needs of orphaned children. [ABSTRACT FROM AUTHOR]

It is timely to have this kind of study in South Africa as the country has an increasing number of people living with HIV and AIDS. While an extensive literature has documented factors associated with HIV and AIDS, psychosocial variables associated with the health of persons living with HIV (PLH) have only begun to receive attention recently. The objective of this paper was to explore the views of a group of people living with HIV and AIDS regarding HIV and AIDS and Self-Forgiveness. Theoretical base: To examine the role of self-forgiveness in people living with HIV and AIDS, George Engel's Biopsychosocial Model was adopted. Methods: Individual In-depth Interviews were conducted with 10 purposefully-selected participants in Ekurhuleni. Outcomes: Results showed that self-forgiveness has a huge role in the lives of people living with HIV and AIDS. For instance, it has been found that self-forgiveness leads to acceptance of HIV status, promote infected people to seek medical care, and eventually gain the confidence to disclose to friends and families. Work implications: In conclusion, self-forgiveness has micro, messo and macro implications as it promotes good health of people living with HIV and AIDS; enhance HIV status self-disclosure and adherence to HIV treatment. [ABSTRACT FROM AUTHOR]

This paper examines whether tobacco expenditure leads to the crowding out or crowding in of different expenditure items in South Africa. We apply genetic matching to expenditure quartiles of the 2010/2011 South African Income and Expenditure Survey. Genetic matching is a more appealing approach for dealing with the endogeneity of tobacco expenditure that often plagues studies using systems of demand equations. Further, genetic matching provides transparent measures of covariate balance giving the analyst objective means of assessing match success. We find that the poorest tobacco consuming households in South Africa consistently allocate smaller budget shares towards food items than non-smoking households. Specifically, we find that dairy, fruits, nuts and oils are displaced in favour of tobacco expenditure in the two poorest quartiles. Unsurprisingly, food items are never displaced for households in the top two quartiles, given these households’ greater access to resources. Like other studies in the literature, we find that tobacco expenditure consistently crowds-in alcohol across all quartiles confirming the strong complementarities between the two. [ABSTRACT FROM AUTHOR]

Background:Indigenous health matters have largely been neglected in the speech-language pathology literature and have particular import for the aphasia clinician. The influence of culture on people’s experiences and expectations after an event such as stroke can vary widely and there is a need to understand the impact of context on assessment and therapy. Standard approaches may not be adequate or relevant, nor always ethical to apply. Examination of aphasia in contexts with Indigenous populations provides an opportunity to explore methods and approaches with socially complex and marginalised communities and to expand our understanding of the lived experience of aphasia. Aims:The goal of this paper is to explore the role of culture in aphasia in Indigenous populations and drawing from a body of emerging research, highlight relevant dimensions of understanding and practice for the aphasia clinician. Main Contribution:A series of qualitative studies undertaken with Indigenous people with aphasia in two separate contexts – Australia and South Africa – will be described and their findings considered along several dimensions. A consideration of methods of approach and understanding will be provided, followed by discussion of some central constructs. A series of conceptual and clinical propositions for culturally safe research and practice in aphasia will be derived from this evidence. Models of collaboration are derived which are decolonising and potentially transformative and supplement models of knowledge and intervention in a local community. Particular attention is paid to temporal and spatial issues, the role of family, identity and community, the notion of resilience in such communities and addressing some of the specific challenges that may be involved such as working with cultural brokers. A series of recommendations is provided which allows for a critical engagement with interdisciplinary frameworks of understanding aphasia in context. Conclusion:As a reflective piece, this paper has enabled a collation of knowledge about aphasia in two Indigenous cultures and has helped consolidate some novel principles and insights and the need for expanded skills, attitudes, insights, explanations and methodologies – ones that acknowledge and accommodate diversity and difference, and that are relevant to Indigenous communities. Language difficulties are only one cause of social exclusion and issues such as poverty and identity make a huge impact on the lives of our clients and their families, and on the approach we adopt. A shift from the primary framework of our profession is required to accommodate the central role of culture in communication. [ABSTRACT FROM PUBLISHER]

Across South Africa there is a growing body of work that explores gender dynamics in heterosexual relationships between young people aged 15–24 years. This is mainly influenced by the high prevalence of HIV and the incidence of intimate partner violence in this age group. Most studies to date have been based upon non-disabled young people, with limited focus on young disabled people. In an attempt to address this gap, this paper describes findings from a study conducted with 22 Zulu-speaking young people with visual and physical disabilities in KwaZulu-Natal. Throughout the findings, young disabled participants appeared to downplay their disability with respect to intimate relationships and accentuated the interweaving of complementary and contentious discourses of gender and cultural identity. Taking cognisance of the intersectionality of gender and cultural discourses, the paper extend constructs of disabled sexualities beyond an exclusive gaze on disability in the South African context. [ABSTRACT FROM PUBLISHER]

Against the background of increasing international calls for the development and implementation of age-appropriate programmes that address both quality and access issues to improve adolescent and youth health, this paper explores the extent to which public health facilities are available and accessible to adolescents and youth in South Africa. The impetus for the study was the current evidence that there was generally poor utilisation of services offered at public health facilities by young people in the country. The overall findings are that despite the country's comprehensive legal and policy framework and commitment to improve the health of young people, there continues to be some structural and systemic factors that hamper effective provision and programming of adolescent and youth friendly services. The paper concludes with recommendations for policy and practice. [ABSTRACT FROM AUTHOR]

A perceived opportunity for improved livelihoods has made Johannesburg a target destination for many internal migrants moving within the borders of South Africa, as well as for cross-border migrants from around the continent and beyond. As a result, many migrants-especially those with irregular documentation-engage in unconventional and sometimes criminalised livelihood strategies, including sex work. This paper uses empirical data from a 2010 mixed methods research study that included a participatory photography project with 11 migrant women from Zimbabwe and elsewhere in South Africa, who sold sex in the migrant-dense suburb of Hillbrow, in inner-city Johannesburg. By focussing on the diverse lived experiences of migrant women who sell sex, this paper examines the ways in which these women survive, engage, and experience their work and the city. Feelings of excitement as a result of new experiences, opportunities for new identities and dreams to be formed, sentiments of nostalgia, concerns and experiences of violence, pride in the ability to survive and earn an income, feelings of loneliness, and negotiations of stigma surfaced throughout the study as participants explained, represented and examined their lives. [ABSTRACT FROM AUTHOR]

This paper reports part of the findings from a 2014 audit of shelters for street children conducted in four provinces of South Africa. The paper focuses on the assessment of the types, structure and implementation of the programmes, as well as on the adequacy of resources necessary for implementing the programmes. The overall picture that emerged from the assessment was that all shelters draw on a comprehensive and enabling legislative and policy framework to offer some elements of developmental, therapeutic and recreational programmes at the early intervention level. Overall, however, the implementation of the programmes does not effectively take into consideration the varied and interconnected factors that, within and across multiple social systems, impel children to the streets. It was thus apparent that the programmes do not adequately address the risks and opportunities of street children in South Africa, specifically within the eco‐developmental framework. Recommendations are offered for social work policy and practice to further enhance the quality and impact of programmes offered in the shelters. [ABSTRACT FROM AUTHOR]

Voluntary medical male circumcision is an integral part of the South African government’s response to the HIV and AIDS epidemic. Following circumcision, it is recommended that patients abstain from sexual activity for six weeks, as sex may increase the risk of female-to-male HIV transmission and prolong the healing period. This paper investigates the resumption of sexual activity during the healing period among a cohort of school-going males in the KwaZulu-Natal province of South Africa. The analysis for this paper compares two groups of sexually active school-going males: the first group reported having sex during the healing period (n = 40) and the second group (n = 98) reported no sex during the healing period (mean age: 17.7, SD: 1.7).The results show that 29% (n = 40) of young males (mean age: 17.9, SD: 1.8) who were previously sexually active, resumed sexual activity during the healing period, had on average two partners and used condoms inconsistently. In addition, those males that engage in sexual activity during the healing period were less inclined to practice safe sex in the future (AOR = 0.055, p = 0.002) than the group of males who reported no sex during the healing period. These findings suggest that a significant proportion of young males may currently and in the future, subject themselves to high levels of risk for contracting HIV post circumcision. Education, as part of a VMMC campaign, must emphasize the high risk of HIV transmission for both the males their partners during the healing period. [ABSTRACT FROM AUTHOR]

This paper focuses on the aesthetics of the fine art, photographic representation of the dead body in Pieter Hugo’s photographic series,The Bereaved, produced in 2005. The series consists of four close-up colour photographs of the faces of men who died of AIDS-related illnesses and were photographed in their caskets, in an informal morgue in Khayelitsha, Cape Town, South Africa. Katarzyna Majak’s theory of socialisation as an attempt to lessen the scandal of the corpse through representation is central as an analytical tool throughout this paper. Majak argues that for the viewer the corpse is a scandal, because it discomfortingly presents the transformation of a body from subject to object. For Majak, socialisation is essentially the taming of the dead body, achieved by re-presenting the corpse as an individual. This paper expands on Majak’s valuable theory by arguing that socialisation is a continuum between emphasising the subject-ness of the deceased individual, rather than the object-ness of the corpse as matter. Importantly, this continuum reveals varying degrees of socialisation within Hugo’s series, and other fine art examples discussed. Socialisation offers an alternative reading of the series concerned with the absence of the subject created by death and representation. [ABSTRACT FROM AUTHOR]

Background and Introduction: Previous studies of soil eating, or geophagia, among pregnant women in sub-Saharan Africa indicate the practice is widespread. Various explanations have been explored to explain the global phenomenon of soil eating, with the most compelling explanation focused on clay's ability to prevent or treat intestinal infection. The urban South African context for clay eating is not well understood. This paper explores clay consumption amongst pregnant migrants who are nationals of countries where clay consumption may be common.Methods: I conducted in-depth interviews with a purposively selected group of Somali, Congolese, and Zimbabwean women (n = 23). Interviews included questions broadly related to maternal and infant nutrition. In addition, I conducted nine focus group discussions (n = 48) with adult Somali, Congolese (DRC), and Zimbabwean men (N = 3) and women (N = 6), segregated by country of origin and gender. This paper focuses specifically on responses related to geophagia.Results: While Somali women did not report consuming clay or charcoal, Congolese and Zimbabwean participants self-reported commonly consuming clay during pregnancy, and at times also when not pregnant. Despite having heard public health messaging that discouraged the practice, participants largely did not describe this consumption in terms of health, but rather in terms of craving and habit. Participants described continued consumption of clay in South Africa, and the only reason for ceasing consumption was in cases of severe constipation.Discussion: The widespread consumption of clay soil by Congolese and Zimbabwean women during pregnancy may be a mechanism through which identity was reasserted and reproduced in a foreign country. Participants' emphasis on clay consumption seemed related to the absence or expense of other craved foods, and perhaps also to feelings of loss in Cape Town. [ABSTRACT FROM AUTHOR]

Background: Although empirical evidence suggests that the adherence club model is more effective in retaining people living with HIV in antiretroviral treatment care and sustaining medication adherence compared to standard clinic care, it is poorly understood exactly how and why this works. In this paper, we examined and made explicit how, why and for whom the adherence club model works at a public health facility in South Africa. Methods: We applied an explanatory theory-building case study approach to examine the validity of an initial programme theory developed a priori. We collected data using a retrospective cohort quantitative design to describe the suppressive adherence and retention in care behaviours of patients on ART using Kaplan-Meier methods. In conjunction, we employed an explanatory qualitative study design using non-participant observations and realist interviews to gain insights into the important mechanisms activated by the adherence club intervention and the relevant contextual conditions that trigger the different mechanisms to cause the observed behaviours. We applied the retroduction logic to configure the intervention-context-actor-mechanism-outcome map to formulate generative theories. Results: A modified programme theory involving targeted care for clinically stable adult patients (18 years+) receiving antiretroviral therapy was obtained. Targeted care involved receiving quick, uninterrupted supply of antiretroviral medication (with reduced clinic visit frequencies), health talks and counselling, immediate access to a clinician when required and guided by club rules and regulations within the context of adequate resources, and convenient (size and position) space and proper preparation by the club team. When grouped for targeted care, patients feel nudged, their self-efficacy is improved and they become motivated to adhere to their medication and remain in continuous care. Conclusion: This finding has implications for understanding how, why and under what health system conditions the adherence club intervention works to improve its rollout in other contexts. [ABSTRACT FROM AUTHOR]

This paper explores barriers to gender policy implementation arising from the narratives framing gender as a policy issue. Through examining the influence of gender policy narratives on practitioners, it challenges those who represent policy failures as the result of unsupportive cultural contexts. The paper draws on Fraser’s (1995, 2005; Fraser and Honneth, 2003) conceptualisation of recognition and redistribution to highlight tensions between three different gender policy narratives: (1) gender as instrumental for development; (2) gender as women’s rights and empowerment; and (3) gender as relations of power requiring personal transformation. Interviews with 32 gender practitioners in 26 South African non-governmental organisations and observations of meetings between these organisations show how these narratives lead to unhelpful conflicts between practitioners. These conflicts inhibit both the uptake of gender policy recommendations and collaboration between practitioners in ways that undermine efforts to address gender inequalities in the South African context. [ABSTRACT FROM AUTHOR]

In many sub-Saharan African communities, caring for vulnerable children in the era of HIV/AIDS appears to be creating deep financial, physical and psychological strains for care-givers, the great majority of whom are ageing women or ‘grandmothers’. Yet, limited primary research has been carried out with older women in specific communities, and therefore grandmothers' collective responses, sources of support, complex lived experiences, and diverse family situations are not well understood. This paper presents the findings of research undertaken in four communities in KwaZulu-Natal, South Africa, between 2006 and 2010. The purpose was to understand the daily stresses, collective responses and mobilisations of older women in these communities. The research involved repeated focus groups, interviews and participant observation involving approximately 100 older women. In the analysis, attention is given to the diversities among participants, the ways in which HIV/AIDS intermingles with other stresses in their lives to drive their mobilisations, and their collective responses, even amidst highly constrained conditions. Through these lenses, the paper illuminates how older women in these communities are organising in response to the combined, devastating and diverse effects of HIV/AIDS, poverty, violence and illness. It also suggests that, counter to some stereotyping of ‘African grandmothers’ as frail or passive, these women are forming associations in order to generate incomes, resist stigma, connect with broader support networks and provide care to hundreds in their communities. [ABSTRACT FROM PUBLISHER]

People living with HIV facing impairments and subsequent disabilities related to the virus and its treatment require involvement of a collaborative team of healthcare professionals to ensure reintegration into daily life and community living. Healthcare teams responsible for this care include doctors and physiotherapists. This paper explores the collaboration of doctors and physiotherapists in the rehabilitation of people living with HIV in a semi-rural healthcare setting in KwaZulu-Natal, South Africa. Six doctors and two physiotherapists were interviewed using a semi-structured interview guide. The qualitative approach led to the emergence of five themes, namely a biomedical versus biopsychosocial approach; scope of practice challenge; multidisciplinary team enigma; institutional structure limitations; and recommendations from healthcare professionals. Both groups of professionals believed that a lack of understanding of the scope of practice and role of the associate profession in the multidisciplinary team led to poor referrals and lack of communication. Furthermore, shortage of personnel and resource limitations posed barriers to effective team interaction. Timely referrals, good communication and understanding of roles were suggested as endorsements to improved collaboration. [ABSTRACT FROM AUTHOR]

Background: Operational research is required to design delivery of pre-exposure prophylaxis (PrEP) and early antiretroviral treatment (ART). This paper presents the primary analysis of programmatic data, as well as demographic, behavioural, and clinical data, from the TAPS Demonstration Project, which offered both interventions to female sex workers (FSWs) at 2 urban clinic sites in South Africa.Methods and Findings: The TAPS study was conducted between 30 March 2015 and 30 June 2017, with the enrolment period ending on 31 July 2016. TAPS was a prospective observational cohort study with 2 groups receiving interventions delivered in existing service settings: (1) PrEP as part of combination prevention for HIV-negative FSWs and (2) early ART for HIV-positive FSWs. The main outcome was programme retention at 12 months of follow-up. Of the 947 FSWs initially seen in clinic, 692 were HIV tested. HIV prevalence was 49%. Among those returning to clinic after HIV testing and clinical screening, 93% of the women who were HIV-negative were confirmed as clinically eligible for PrEP (n = 224/241), and 41% (n = 110/270) of the women who were HIV-positive had CD4 counts within National Department of Health ART initiation guidelines at assessment. Of the remaining women who were HIV-positive, 93% were eligible for early ART (n = 148/160). From those eligible, 98% (n = 219/224) and 94% (n = 139/148) took up PrEP and early ART, respectively. At baseline, a substantial fraction of women had a steady partner, worked in brothels, and were born in Zimbabwe. Of those enrolled, 22% on PrEP (n = 49/219) and 60% on early ART (n = 83/139) were seen at 12 months; we observed high rates of loss to follow-up: 71% (n = 156/219) and 30% (n = 42/139) in the PrEP and early ART groups, respectively. Little change over time was reported in consistent condom use or the number of sexual partners in the last 7 days, with high levels of consistent condom use with clients and low use with steady partners in both study groups. There were no seroconversions on PrEP and 7 virological failures on early ART among women remaining in the study. Reported adherence to PrEP varied over time between 70% and 85%, whereas over 90% of participants reported taking pills daily while on early ART. Data on provider-side costs were also collected and analysed. The total cost of service delivery was approximately US$126 for PrEP and US$406 for early ART per person-year. The main limitations of this study include the lack of a control group, which was not included due to ethical considerations; clinical study requirements imposed when PrEP was not approved through the regulatory system, which could have affected uptake; and the timing of the implementation of a national sex worker HIV programme, which could have also affected uptake and retention.Conclusions: PrEP and early ART services can be implemented within FSW routine services in high prevalence, urban settings. We observed good uptake for both PrEP and early ART; however, retention rates for PrEP were low. Retention rates for early ART were similar to retention rates for the current standard of care. While the cost of the interventions was higher than previously published, there is potential for cost reduction at scale. The TAPS Demonstration Project results provided the basis for the first government PrEP and early ART guidelines and the rollout of the national sex worker HIV programme in South Africa. [ABSTRACT FROM AUTHOR]

This paper aims to contribute to recent reflections on training in psychoanalytic practice in South Africa and internationally in response to growing recognition that psychoanalytic practitioners need to be well equipped to deal with contemporary mental health challenges. Rather than add to the central and recurrent themes that authors have already identified as important areas of development in psychoanalytic training my aim is to take a more deconstructive approach. This approach involves engaging with the ways in which contemporary psychoanalytic training is constructed and the kinds of assumptions that could be described as 'haunting' these constructions. The approach also involves conceptualising these constructions and their assumptions as non-accidental. While they are clearly based in extensive engagement with experience and already existing knowledge, they might also be understood as serving particular unconscious purposes. In particular, this paper draws on psychoanalytic theorising on sibling relationships to think about the possible unconscious libidinal attachments to these constructions. In line with a psychoanalytic inquiry, my aim is to draw attention to the elements that are lurking in the margins of future training directives. [ABSTRACT FROM AUTHOR]

Policymakers at global level recognise that household biomass use in developing countries has significant health consequences. However, it is unclear how local-level health professionals perceive and respond to such health effects. This paper which is derived from the findings of a larger study on perceptions and responses to the harmful health effects of carrying heavy firewood loads and to smoke from cooking fires is based on a study conducted in South Africa among managers of health programmes and community nurses of Qaukeni and Mhlontlo municipalities in rural Eastern Cape. Interviews and participant observations were conducted in 2009 using ethnographic grounded theory approaches. In addition to a 10-month period of ethnographic fieldwork, ten programme managers and nurses in two villages were interviewed about health patterns in the villages that they serve, their perceptions of, and responses to the health effects of carrying heavy firewood loads, and inhalation of smoke from wood and dung cooking fires, their professional qualifications and experience, their own household energy use; and observations made as they served clinic clients. Results show that these programme managers and nurses perceive the health effects of carrying heavy loads of firewood and of cooking smoke as minor. Sometimes, nurses give women symptomatic relief for musculoskeletal pain resulting from carrying heavy loads. We posit that their perceptions are derived from customary neglect of work-related health and non-communicable diseases, cultural interpretations of womanhood, limited access to relevant information, and limited interactions between health and energy sector professionals. We conclude that culturally and gender-sensitive awareness programmes are needed for local-level health professionals to effectively address health effects of biomass collection and use. This paper provides new insights into overlooked differences between globally-driven initiatives to address health effects of biomass use and local perceptions. [Copyright &y& Elsevier]

This paper focuses on the role of 'social support' in the experience of fibromyalgia (a musculoskeletal pain disorder) in South Africa. In-depth semi-structured interviews were used to collect narratives from 15 participants. Sources of social support constitute important mechanisms for coping with the illness experience of fibromyalgia. In providing a space for consultation and validation of the diagnosis of fibromyalgia, and the person living with the condition, people giving support fulfil a critical role in shaping the experience. The findings show how support from family, partners, and peers plays an integral role in the process of accepting fibromyalgia diagnosis, adapting to the demands of the condition, and seeking help from healthcare providers. The findings also show the ways in which people with fibromyalgia provide support for others with the condition, and the importance of this peer network in shaping the paths and outcomes of this illness experience. The findings of this study corroborate existing evidence that show fibromyalgia to be a complex condition to manage, due to the multiplicity, uncertainty and contestation that feature in the experience of the illness. Additionally, this study presents the challenges related to the limitations of access to healthcare in the South African context, and the utility of narrative approaches in garnering insight into the ways in which social support is harnessed in this environment. [ABSTRACT FROM AUTHOR]

In predominantly isiXhosa-speaking township communities in South Africa, men who have sex with men negotiate their identities and sexual practices alongside heteronormative cultural scripts of what it means to be a man. Such idealised notions of masculinity are predicated on the selective appropriation of cultural practices that preserve (heterosexual) male privilege and power. In this paper, we explore the identity work done by men who have sex with men, with particular reference to male circumcision as a cultural practice widely drawn on to inform and regulate normative masculinity. Through a narrative-discursive analysis of the accounts provided by men who have sex with men from township communities, we highlight how participants’ dissident sexualities are constructed as compromising their masculine identities. Participating in cultural practices such as traditional circumcision aligns participants to the idealised forms of masculinity that afford men full citizenship in their communities. Study findings suggest that sexual dissidence is less troubling to participants than deviating from gendered markers of hegemonic masculinity, and point to ways in which marginalised men might have an interest in maintaining the dominant gendered order. We conclude with implications for research and programmatic work with gay, bisexual and other men who have sex with men. [ABSTRACT FROM PUBLISHER]

Accessible summary The purpose of this study was to describe the role of inclusiveness in lessening the pain of parents death in adolescents orphaned by AIDS., Data were derived from 15 AIDS orphans between the ages of 14 and 18 years., The method used was focus groups with discourse analysis using four themes: grieving patterns, coping strategies, experience with loss and expectations., The participants believed that including them in the illnesses, dying and funeral preparations of their parents would have facilitated their healing., Abstract The purpose of this paper is to raise an argument that inclusiveness will lessen the pain of losing a parent among adolescents orphaned by AIDS and as a result, prevent future mental health problems that may occur because of inappropriate grieving and maladaptive coping strategies. Participation of adolescents orphaned by AIDS in decisions pertaining to their parents' illnesses and funeral arrangements, for example, may shorten the grieving process and allow for closure. The paper draws data from focus group discussions that were held with 15 adolescents orphaned by AIDS in urban South Africa. The focus group discussions that were structured around four themes: grieving patterns; coping strategies; experience with loss; and expectations. The results of the study demonstrate inclusiveness as an overarching factor in the healing process. The concept is thus a strong recommendation for mental health practice and further study. [ABSTRACT FROM AUTHOR]

This paper takes the form of an account of the emergence of the field of psychoanalytically informed parent-infant/child psychotherapy in South Africa. It traces the origins and the development of the South African field by locating local practice within the international field. The influential links between international approaches and local practice and services are described. The historical account is based on a review of published parent-infant/child literature, including South African authored texts. Interviews with key local stakeholders and practitioners supplement the literature review. This paper endeavours to locate parent-infant/child psychotherapy more clearly on the map of mental health work in South Africa, and in so doing to promote the work as both a relevant and valuable intervention. [ABSTRACT FROM PUBLISHER]

Drawing upon a one-year-long ethnography of boys' constructions of their gender and sexual identities in one South African high school, this paper seeks to empirically explore and theorise how 58 grade 10 and grade 11 working-class boys create and seek out spaces among their male peers from which to cultivate their masculinities through heterosexual discourses, including being 'at risk' of getting AIDS. In this study, boys' daily struggles of trying to straddle the divide between hypersexual versus homosexual/effeminate versions of masculinity both subverted and reinforced hegemonic gender/sexual relations in the school context. Being caught up in this restrictive grip of heteronormativity meant that there were few spaces in male peer culture to resist hegemonic masculinity. The 'responsible male/controlled' position is indicative of one such space in which boys attempted to resist forms of hyper-sexuality. While this position cannot really be viewed as progressive, it nevertheless allowed boys to re-position themselves as moral agents through an assertion of control over their sexuality. Given the presence of these identity struggles, this paper, in general, suggests that interventions with boys need to cautiously explore these tensions/contradictions in identity making as opportunities to cultivate more gender sensitive and less violent discourses on masculinity. [ABSTRACT FROM AUTHOR]

The United Nations estimates that 79% of teenage girls trafficked globally every year are forced into involuntary prostitution. About 247 000 South African children work in exploitative conditions; about 40 000 South African female teenagers work as prostitutes. This paper investigates lifestyles and routine activities of teenagers at risk of being trafficked for involuntary prostitution. The key concepts involuntary prostitution, intergenerational sex and exploitative conditions are defined in relation to the lifestyles and routine activities of South African female teenagers. Human trafficking for involuntary prostitution is described, based on a literature review. Lifestyle exposure and routine activities theories help to explain the potential victimisation of these teenagers in human trafficking for involuntary prostitution. Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are discussed as factors that make teens vulnerable to such trafficking. This paper recommends that human trafficking prevention efforts (awareness programmes and information campaigns) be directed at places frequented by human traffickers and teenagers in the absence of a capable guardian to reduce victimisation, as traffickers analyse the lifestyles and routine activities of their targets. South Africa should also interrogate entrenched practices such as intergenerational sex. [ABSTRACT FROM AUTHOR]

Responsive to perceived high risk of HIV infection by sexually active youth, several South African sexual health-promotion campaigns have used media targeting mothers, instructing them on how sex should be talked about with their children to 'risk-proof' them. A Foucauldian approach to the normative apparatus of family-sexuality-risk finds mothers positioned as pivots between 'public' (health, economy, culture) and 'private' (family, childrearing, sex) apparatuses, tasked with appropriately socialising a new generation of sexually responsible, HIV-free citizens. This paper uses a reading of interactive discourse from (racially and gender) mixed groups of parents who, as professionals and postgraduate students in a university context, discussed their own childrearing practices in response to a particular didactic media text about sex-communication. In a way different from traditional media-reception studies, this discourse analytic reading of parents' engagement with risk-expertise examines how mothers especially are persuaded (or not) to adopt particular childrearing practices in the context of an HIV epidemic. Using a Foucauldian argument about subject positioning, this paper examines how the parents positioned themselves in relation to the expertise offered in the stimulus material, as well as how they positioned one another during the group discussions. The analysis explores the partial buy-in to expert Western psychological techniques concerning talking with children about sex openly and often, and how this appropriation is negotiated in contextual family situations that are gendered, raced, classed and acculturated. [ABSTRACT FROM AUTHOR]

The origin and development of counselling psychology in South Africa has been profoundly influenced by the country's sociopolitical history and the impact of apartheid. As a result of this, counselling psychologists in the country face a number of challenges and opportunities for the future. In this paper we provide a portrait of counselling psychology in South Africa by describing the current character of the specialty and the context in which South African psychologists work. We critically discuss the challenges that the specialty faces to meet the country's mental health care needs, contest the current Scope of Practice; affirm multiculturalism without essentialising or reifying race and ethnicity, and build an evidence base for community interventions in the country. We also consider how, in the future, counselling psychologists in South Africa may make a more meaningful contribution within public health and the country's health care and education systems. [ABSTRACT FROM AUTHOR]

In 1994, South Africa approved a constitution providing freedom from discrimination based on sexual orientation. Other Southern African countries, including Botswana, Malawi, and Namibia, criminalize same-sex behavior. Men who have sex with men (MSM) have been shown to experience high levels of stigma and discrimination, increasing their vulnerability to negative health and other outcomes. This paper examines the relationship between criminalization of same-sex behavior and experiences of human rights abuses by MSM. It compares the extent to which MSM in peri-urban Cape Town experience human rights abuses with that of MSM in Gaborone, Botswana; Blantyre and Lilongwe, Malawi; and Windhoek, Namibia. In 2008, 737 MSM participated in a cross-sectional study using a structured survey collecting data regarding demographics, human rights, HIV status, and risk behavior. Participants accrued in each site were compared using bivariate and multivariate logistic regression. Encouragingly, the results indicate MSM in Cape Town were more likely to disclose their sexual orientation to family or healthcare workers and less likely to be blackmailed or feel afraid in their communities than MSM in Botswana, Malawi, or Namibia. However, South African MSM were not statistically significantly less likely experience a human rights abuse than their peers in cities in other study countries, showing that while legal protections may reduce experiences of certain abuses, legislative changes alone are insufficient for protecting MSM. A comprehensive approach with interventions at multiple levels in multiple sectors is needed to create the legal and social change necessary to address attitudes, discrimination, and violence affecting MSM. [ABSTRACT FROM AUTHOR]

Sexual risk-taking is influenced by individual, interpersonal and social factors. This paper presents findings from a qualitative follow-up study to a clinical trial evaluating biomedical HIV prevention products among African women, explored participants’ perceptions and experiences of heterosexual penile-anal intercourse, as well as the gendered power dynamics and relationship contexts in which this sexual behaviour occurs. In-depth interviews were conducted with 88 women from South Africa, Uganda and Zimbabwe. Findings reveal that despite its social stigmatisation, women engage in penile-anal intercourse for reasons including male pleasure, relationship security, hiding infidelity, menstruation, vaginal infections, money and beliefs that it will prevent HIV transmission. In addition, participants described experiences of non-consensual penile-anal intercourse. We used sexual scripting theory as an analytical framework with which to describe the sociocultural and relationship contexts and gendered power dynamics in which these practices occur. These data on the distinct individual, dyadic and social contexts of heterosexual penile-anal intercourse, and the specific factors that may contribute to women’s HIV risk, make a unique contribution to our understanding of heterosexual behaviour in these sub-Saharan countries, thereby helping to inform both current and future HIV prevention efforts for women in the region. [ABSTRACT FROM PUBLISHER]

This paper focuses on the psychologization of development in South Africa, one of the most unequal countries in the world, through a critical analysis of a discussion on a national radio programme about the meaning of Mandela Day. We demonstrate how speakers draw on common sense notions of race, class, and party politics that (re)produce subject positions from within a rights-based interpretive repertoire that emphasizes structural reform and class resistance, and an agency interpretive repertoire that emphasizes individualism, responsibility, and volunteerism. We further demonstrate how the agency subject position serves to stifle and resist the rights subject position by drawing on common sense “psychological truths” about what it means to be a good citizen. [ABSTRACT FROM PUBLISHER]

Research suggests that South African youth use silence as a sign of respect and gratitude and to maintain family and kinship bonds. There has not been much research to help us better our understanding of this phenomenon. This paper explores the strategic use of silence in narratives of absent fathers collected from the Mpumalanga province. Twenty-one-hour, one-on-one, fieldworker-respondent, semi structured interviews in their local languages, were conducted with women aged 15-26 years old. Interviews were gender-matched, audio-recorded, transcribed verbatim and translated into English. Thematic, and some elements of discourse analysis, were used to analyse the data focusing on motivations behind silence in familial relationships. Findings show that motivations for upholding silence within the home were to show respect and gratitude, and avoid upsetting a bothersome mother. The dynamics of silence reported here are similar to those found in narratives of psychological distress and abuse among young South Africans. A novel theme was that of avoiding speaking with a chronically ill mother lest this made her condition worse and recovery difficult. This research suggests a need to equip young women with ways of expressing themselves within families without fear of being seen as disrespectful, ungrateful and a burden to others. [ABSTRACT FROM AUTHOR]

Men and women living with HIV with access to ARVs are living longer, healthier lives that can and often do include bearing children. Children occupy a key space in men and women's personal and social lives and often play a fundamental role in maintaining these relationships, irrespective of illness concerns. Couples living with HIV need to balance prevention needs and ill-health while trying to maintain healthy relationships. Health-care providers serving the reproductive needs of HIV-affected couples need to consider the social and relational factors shaping reproductive decisions associated with periconception risk behaviors. This paper based on qualitative research at three hospital sites in eThekwini District, South Africa, investigates the childbearing intentions and needs of people living with HIV (PLHIV), and the attitudes and experiences of health-care providers serving the reproductive needs of PLHIV, and client and provider views and knowledge of safer conception. This research revealed that personal, social, and relationship dynamics shape the reproductive decisions of PLHIV, and “unplanned” pregnancies are not always unintended. Additionally, conception desires are not driven by the number of living children; rather clients are motivated by whether or not they have had any children with their current partner/spouse. Providers should consider the relationship status of clients in discussions about childbearing desires and intentions. Although many providers recognize the complex social realities shaping their clients' reproductive decisions, they have outdated information on serving their reproductive needs. Appropriate training to enable providers to better understand the relationship and social realities surrounding their clients' childbearing intentions is required and should be used as a platform for couples to work together with providers toward safer conception. The adoption of a more participatory approach should be employed to equalize client–provider power dynamics and to ensure clients are more involved in decision-making about reproduction and conception. [ABSTRACT FROM AUTHOR]

The role of school psychologists has been debated and contested nationally and internationally for many decades, with an emphasis on the need for a paradigm shift in professional roles. Psychologists may be employed in the private sector, in nongovernmental organisations, in higher education institutions, and by the state. Those employed by the state within the Department of Basic Education are referred to as school psychologists, and are tasked with providing psychological services to public schools. In the Western Cape, the context of this study, school psychologists are assigned to circuit teams, where they are expected to work collaboratively with other professionals to provide support to schools. This paper is focused on school psychologists' perceptions of the challenges that emerge when working with other sectors to facilitate school development. Eight focus group discussions were conducted with 47 school psychologists. The data collected resulted in the generation of five categories of challenges facing school psychologists when they collaborate with other sectors to facilitate school development. These were: diverse discourses and worldviews; roles and boundaries; personal and interpersonal factors; training needs; and organisational challenges. This research contributes towards the deepening of school psychology practice, and to providing important insights towards the enhancement of intersectoral collaboration and school development as aspects of the provision of support to schools in South Africa. [ABSTRACT FROM AUTHOR]

This paper reports on participants' views regarding factors contributing to the vulnerability of teenagers with intellectual disability to sexual abuse. The study took place at two special schools located in a village of KwaZulu-Natal. Data were gathered using by individual interviews, which were conducted in a face-to-face manner with life orientation teachers (8), school nurses (2), a clinical psychologist at the local hospital, and social workers (2). The interviews were also conducted with two parents, a traditional healer and spiritual diviner. Data was thematically analysed. The vulnerability factors were grouped into three broad categories, namely: individual, family and community factors. The existence of a number of vulnerability factors suggests that efforts to mitigate the problem should occur at various levels, with which an individual is interacting. [ABSTRACT FROM AUTHOR]

With the anticipated publication of the DSM-5 in May 2013, much reflection and work has been done on reviewing existing psychiatric nomenclature including, but not limited to the field of traumatic exposure. Traditionally, understanding of the psychiatric and psychological effects of trauma have been developed from studies with adults and then applied to trauma-exposed children with some modifications. While this is an important step to understanding the sequelae of trauma in children and adolescents, the adverse developmental effects of traumatic exposures on the rapidly evolving neurological, physical, social and psychological capacities of children calls for a developmentally sensitive framework for understanding, assessing and treating trauma-exposed children. The importance of early attachment relationships in infancy and childhood means that severely disrupted early caregiving relationships may have far-reaching and lifelong developmental consequences and can therefore be considered traumatic. Given the high rates of violence and trauma exposure of South African children and adolescents, the need for a developmentally based understanding of the effects of trauma on child and adolescent mental health becomes even more pronounced. In this paper, we draw on theoretical perspectives to provide a practical, clinically driven approach to the management of developmental trauma. [ABSTRACT FROM PUBLISHER]

As South Africa prepared to host the 30th International Congress of Psychology in 2012, a call was made to reflect on the strengths of and challenges facing contemporary South African Psychology. This article presents our response to our brief to focus on social issues by presenting the results of a situational analysis of South African Psychology over the last 5 years and comparing this corpus of data to a similar analysis reported in Macleod. Articles appearing in the South African Journal of Psychology and abstracts in PsycINFO with the keyword ‘South Africa’ over a 5.5-year period were analysed. The content of 243 South African Journal of Psychology articles and 1986 PsycINFO abstracts was analysed using the codes developed by Macleod. Results indicate that an increase in the number of articles, a reduction in the percentage of articles using quantitative methodologies and ‘hard’ science theoretical frameworks (particularly in the South African Journal of Psychology), and an increase in qualitative, theoretical, and methodological articles, and articles using systems-oriented theory (particularly in the South African Journal of Psychology). Traditional topics of assessment, stress and psychopathology continue to dominate, with social issues, such as housing, land reform, development programmes, water resources and socio-economic inequities being largely ignored. Most research continues to be conducted in Gauteng, KwaZulu/Natal and the Western Cape, predominantly with adult, urban-based, middle-class participants, sourced mainly from universities, hospitals or clinics, and schools. Collaborations or comparisons with other African, Asian, South American, and Middle East countries have decreased. While the analysis presented in this paper is limited by its exclusion of books, theses, research reports and monographs, it shows that in published research there are some positive trends and some disappointments. The limited number of social issues featuring in published research, the under-representation of certain sectors of the population as participants, and the decrease in collaboration with, or comparison to, countries from the global ‘South’ represent challenges that require systematic attention. [ABSTRACT FROM AUTHOR]

Background: Cultural perspectives about illness influence the experience of illness and disability, shaping the nature of both formal and lay care. However, very little has been written about cultural understandings of aphasia despite a renewed focus on contextual influences. Methods from anthropology have the potential to improve our understanding of this condition. Aims: In this paper we explore understandings of stroke and aphasia in a South African township. We describe how stroke and aphasia is presented and understood by people living in this community, particularly those living with aphasia, their family members, and healthcare workers, and provide examples of how these individuals account for the sudden and long term consequences of stroke. Methods & Procedures: Data are drawn from a broader ethnographic study of the social and cultural experience of aphasia in South Africa that involved a 3-year period of intermittent fieldwork in a township community on the outskirts of Cape Town. Participant observation of the everyday life of a group of five adults living with aphasia and interviews with participants, kin, and healthcare workers was carried out in various settings including homes, clinics, and an adult day care centre. Results & Outcomes: The main result of this study was that causation emerged as an important discussion topic for people living with aphasia as well as for carers and health workers. These discussions were not limited to the search for a biomedical understanding, but reflected multifactorial understandings that were linked to cultural frameworks as well as daily circumstances and social realities. Conclusions: Aphasia is experienced in a sociocultural context. Thus there is theoretical and clinical relevance in using anthropology to explore the world of the adult living with aphasia. [ABSTRACT FROM AUTHOR]

This paper reports on South African teachers' perceptions of the educational value of new topics in a revised physical sciences high school curriculum, their content knowledge competency of these topics, and their pedagogical content knowledge in teaching them. In view of the historical inequalities of the South African education system, a focus of the study was comparison of these perceptions of teachers based at schools which are diverse in terms of location, student population, and availability of resources. We adopted a mixed methods approach in collecting and analysing data from a large-scale survey of teachers through a structured questionnaire, and followed this with interviews with 10 teachers in seeking more in-depth explanations of the findings. The study revealed that teachers at township and rural schools previously designated for black students, and suburban and city schools previously reserved for white students, have a positive perception of the new topics introduced into the revised curriculum. However, teachers at all these schools expressed uncertainly as to their content knowledge and pedagogical knowledge of the new topics. [ABSTRACT FROM AUTHOR]

Mixed methods are becoming increasingly popular in social science research. There has recently been a groundswell of literature suggesting that mixed methods should be viewed as a unique form of social enquiry with its own set of philosophical, methodological and practice guidelines, as opposed to the simple combination of quantitative and qualitative methods in one study. In response to three critiques of South African psychological research, this paper argues that regardless of whether we agree that mixed methods is a unique form of social enquiry, the current literature offers useful insights into conceptualising both mixed and mono methods research. It is hoped that this article will stimulate further interest in mixed methods research in South African psychological research. [ABSTRACT FROM AUTHOR]

During the apartheid era, a key component of the Nationalist government's strategy in combating both African nationalism and the perceived threat of communism was the compulsory conscription of young white men into the South African Defence Force (SADF) between 1968 and 1993. Conscription was one relatively small component of a system in which all South Africans' lives were profoundly affected by the political domain's imposition of racial, class and gender stratifications. This paper is based on ongoing research into the psychosocial legacies of the apartheid wars. It explores how some of the burgeoning publications about this period of South African history reflect the intrapersonal legacies and psychological stresses that were caused by the social and political discourses of this context. A particular focus in this discussion is the way in which the social and political fracturings that characterised South African society during the apartheid era have been mirrored in the psychosocial constructs that significantly shaped some conscripts' lives, both at the time and in the post-apartheid context, and continue to influence current South African society. [ABSTRACT FROM PUBLISHER]

South Africa faces the challenge of supporting the well-being of adults caring for growing numbers of AIDS-orphaned children. These adults play a critical role in responses to the epidemic, but little information exists in regard to their mental health needs. This paper reports on findings from n=1599 adults, recruited through representative household sampling, who serve as primary carers for children in Umlazi Township, an HIV-endemic community. Overall, 22% of participants were carers of AIDS-orphaned children, 11% were carers of other-orphaned children and 67% were carers of non-orphaned children. Prevalence of depression was 30.3%. Orphan carers, regardless of whether they cared for AIDS-orphaned or other-orphaned children, were significantly more likely than carers of non-orphaned children to meet the clinical threshold for depression (35.2% vs. 27.9%, p < 0.01). In multivariate logistic regressions, food insecurity and being a female carer were identified as additional risk factors for greater depression. In contrast, households with access to running water and households dependent on salaries as the main source of income were identified as protective factors for disparities in depression. Mental health interventions are urgently needed to address an increased risk for depression among all orphan carers, not just those caring for AIDS-orphaned children. [ABSTRACT FROM AUTHOR]

In this paper, we investigated the relationship between traditional masculine ideology, body image discrepancy, self-esteem, and the pursuit of muscularity in a sample of school going boys. Constructs were measured using the Traditional Masculine Ideology Scale, Lynch and Zellner's Body Figure Drawings (1999), Rosenberg's Self-Esteem Inventory, and the Drive for Muscularity Scale. Questionnaires were administered to 508 boys, from Grades 10, 11, and 12, at a public single-sex high school in KwaZulu-Natal, South Africa. Analysis revealed significant positive correlations between traditional masculine ideology, the pursuit for muscularity, and body image discrepancy. Indian school boys experienced body image discrepancy more severely than their Black and White counterparts in the sample. Further, there was a significant use of muscle supplements and steroids by school going boys. [ABSTRACT FROM AUTHOR]

In this paper we explore the perceived desirable characteristics of South African Life Orientation teachers for teaching sexuality and HIV/AIDS. We also investigate the extent to which these characteristics can be understood as parts of a role script for teaching HIV/AIDS and sexuality. Data were collected from teachers who taught Grade Eight and Grade Nine students in South African public high schools. The teachers particularly emphasised the importance of personality and life experience as important characteristics for teaching sexuality and HIV/AIDS. In addition, they felt that it was challenging to create an open dialogue in the classroom and at the same time maintain classroom discipline. The teachers did not perceive that teaching about sexuality and HIV/AIDS was a role that a teacher could step in and out of. On the other hand, they were accustomed to playing different roles with respect to the students, such as parent, friend, counsellor and social worker. [ABSTRACT FROM AUTHOR]

A rumour that emerged during a microbicide gel trial tells the tale of clinic staff purchasing trial participants' blood. This paper documents the rumour and explores its divergent interpretations and meanings in relation to the context of the trial and the social and economic setting at two of the trial sites (Soweto and Orange Farm) in South Africa. The article is based on qualitative research conducted during the Microbicides Development Programme (MDP) 301 trial to evaluate a microbicide vaginal gel for HIV prevention in women. The research incorporated in-depth interviews with female trial participants and their male partners, focus group discussions with male and female community members, and participant observation in the trial clinic and community setting at the two sites. The article analyses the different perspectives among the clinic staff, community and trial participants in terms of which the rumour about the exchange of blood for cash is seen as: 1) the result of ignorance of the clinical trial procedures; 2) the exploitation of poor and vulnerable women; 3) an example of young women's desire for material gain; and 4) a reciprocal exchange of 'clean blood' for cash between women trial participants and the health services. We suggest that the rumours about selling blood verbalise notions of gender and morality while also providing an appraisal of the behaviour of young women and a critique of social relationships between foreign researchers and local participants. Through stories about the clinical trial procedures and its potential reimbursements, the participants were creating and reconfiguring social relationships. Ultimately, rumours are one way in which foreign enterprises such as a clinical trial are rendered local. [ABSTRACT FROM AUTHOR]

Foetal alcohol spectrum disorders (FASD) represent a major health, educational, and social challenge in South Africa. By evoking negative responses from the child's environment, the specific constellation of features associated with FASD pose a threat to the development of a positive self-concept in the developing child with FASD. These features particularly relate to mother-infant attachment disturbances, 'difficult' temperament, disruptive behaviour disorders and intellectual deficits leading to poor scholastic performance. While there is a high rate of psychopathology amongst children with FASD, little has been done to formulate these difficulties within established personality theory. Using concepts from self psychology theory, this paper illustrates how some of the features associated with foetal alcohol exposure may compromise the child's developing sense of self, which in turn may increase vulnerability to the development of psychopathology. An argument for employing Kohut's self psychology theory to attain a better understanding of, and clearer strategies for, the treatment of psychopathology in children suffering from FASD is presented. [ABSTRACT FROM AUTHOR]

Casual and contract employment increased in South African food retailing in the 1990s, opening divisions of labor on shop floors among black workers previously unified. Literature on labor mobilization concentrates on institutional strategies to organize contingent workers. Explaining new segmentation among retail workers, this paper finds that a notion of what it meant to be a “worker” is also relevant for explaining obstacles to mobilization. “Worker” legacies were shaped in the 1980s and carried forward with shifting emphases in the post-apartheid period. These processes reproduced a normative notion of worker as full-time, permanent employee and labor rights as codified in a narrowed employment relationship. Casual and contract workers experienced work as a series of exclusions from rights and respect within the workplace vis-à-vis permanent workers. Contingent workers protested their marginalization by reclaiming their inclusion within workplace relations, within a workplace citizenship. In the process, divisions of labor deepened. [ABSTRACT FROM AUTHOR]