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Background: COVID‐19 necessitated emergency telepractice for student‐led speech‐language therapy clinical practicals in training institutions, with limited preparation and evidence‐based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy. Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student‐led telepractice sessions in a diverse, resource‐limited context. The broader goal of this project was to provide evidence‐based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts. Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student‐led paediatric telepractice sessions from a South African university clinic as part of a pilot study. Outcomes & Results: We identified four overarching considerations for student‐led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face‐to‐face contact. Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice. WHAT THIS PAPER ADDS: What is already known on this subject: Many speech‐language therapy (SLT) student clinicians had to transition quickly to telepractice service provision during COVID‐19 with limited existing guidelines and support, especially in contexts where teletherapy is typically non‐existent or difficult to access. Although there is some literature available on experiences of telepractice, there is very little evidence‐based research which explores the mechanics of such sessions in real‐time and which offers practical support to student clinicians and clinical educators engaging in this mode of service delivery. What this study adds: This pilot study examined video‐recorded, student‐led, paediatric, speech‐language teletherapy sessions to understand challenges and considerations involved in using telepractice as a clinical training tool. Findings show that additional preparation for telepractice sessions is required, particularly in contexts of poor digital literacy; students must learn to manage technology, especially when connectivity poses a challenge, and adapt therapy tasks for online work with clients; telepractice relies heavily on caregiver input and collaboration, more so than in in‐person consultations, and this relationship requires careful management; and promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical yet challenging skills in telepractice. What are the potential or actual clinical implications of this work?: Our findings highlight a need to teach telepractice pedagogy explicitly and support students practically in learning how to provide therapy effectively via this mode of service delivery. Observational methods for studying practices in recorded telepractice sessions can be used as part of a reflective approach to clinical training. Using already available data allowed us to unpack the 'messy reality' of clinical training using telepractice. [ABSTRACT FROM AUTHOR]

Feminist scholars have focused on paid domestic labour as a site of gendered inequalities structured by race, gender, class, and citizenship. However, men are largely absent from feminist intersectional understandings of everyday interactions within paid domestic labour. This paper draws on an interview study of South African domestic workers focusing on their talk about interactions with male employers. The analysis demonstrates that talk about routines of the physical and symbolic absence of men can become normalised within domestic labour discourse. This is a narrative that is only brought to light once men's (lack of) presence is made a topic. The conspicuous absence of analyses of this kind within paid domestic labour studies points to unfinished and troubling feminist projects. [ABSTRACT FROM AUTHOR]

Migration to South Africa is motivated by the pursuit of employment, safety, and improved living conditions. However, immigrants encounter significant challenges, such as restricted access to essential services, which were exacerbated by the COVID-19 pandemic. This paper investigates the impact of the COVID-19 pandemic on Malawian immigrants in South Africa, addressing the lack of attention given to this immigrant population by highlighting their vulnerabilities. Using a qualitative exploratory and descriptive approach, in-depth interviews were conducted with 24 Malawi immigrants who were over 18 years old and had established residency in South Africa before the onset of the COVID-19 pandemic. Five key stakeholders were also interviewed for additional perspectives and to ensure triangulation and improve data reliability. The interviews were transcribed verbatim and analyzed using thematic analysis strategies and coding with Nvivo12 software. The study highlighted the exacerbated struggles of Malawian immigrants in South Africa amid the COVID-19 pandemic, uncovering systemic discrimination in healthcare, marked by longer wait times and reluctance from health workers to treat undocumented immigrants. The study also revealed a dire security situation, with immigrants living in high-crime areas and feeling particularly targeted due to their foreign status, a situation worsened by the pandemic's economic effects. Additionally, the economic downturn induced by COVID-19 significantly impacted employment opportunities, with many immigrants facing prolonged unemployment and job losses, especially in sectors where they traditionally found work. The detailed accounts of participants highlight not only the multifaceted challenges imposed by the pandemic but also the critical need for inclusive policies and support systems that ensure healthcare access, safety, and economic resilience for immigrants, particularly during global health emergencies. Future research should focus on effective interventions for socioeconomic integration and well-being, particularly for immigrants from other African countries. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs' experiences of implementing telepractice in the Global South during this time is available. Aims: To explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic. Methods & Procedures: SLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles. Outcomes & Results: We describe participants' reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online. Conclusions & Implications: Telepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs' confidence in providing telepractice whilst delivering quality services in an accessible and safe manner. WHAT THIS PAPER ADDS: What is already known on the subject: Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs' experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners. What this paper adds to existing knowledge: Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic. What are the potential or actual clinical implications of this work?: Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients. [ABSTRACT FROM AUTHOR]

This paper addresses the current debates, anxieties, and perceptions around the idea of scholarly artistic research within doctoral studies, internationally and in South Africa. A common point of contention, both in South Africa and in the international arena, is the reluctance within institutional structures and external bodies to accept artmaking as research and the creative production or artifact as a legitimate component of the research output. Creative practice is permissible at the doctoral level of study but usually research or new knowledge that emerges from such practice is evaluated and analyzed through the lens of textual research. The unwillingness to qualify practice as autonomous research is coupled with its awkward positioning in the humanities as a kind of study secondary to and distinct from that associated with scientific research methodology. This discussion engages with policies, developments, debates, and discourse around practice-based doctoral study in South African and globally, with the hope of presenting a comprehensive overview of the current state of doctoral level artistic research. Moreover, in drawing on international discourse and precedents the study proposes some guidelines, parameters and methodological approaches that can contribute to the understanding and development of doctoral artistic research in South Africa. [ABSTRACT FROM AUTHOR]

Background: A major disparity exists in access to specialised healthcare between rural and urban areas. Specialist outreach programmes are one of the ways in which rural specialist healthcare inequality is being addressed. A number of rural district hospitals (RDH) employ local, private specialists (LPS) to supplement public specialist outreach. Limited research exists on private specialist outreach and support (PSOS) in sub-Saharan Africa or South Africa. Methods: This was a descriptive, exploratory, qualitative study using thematic analysis of semi-structured interviews. Non-probability, purposive sampling was used to obtain a sample size of 16 participants. The audio recordings were transcribed verbatim and analysed with the framework method and ATLAS.ti version 8© software. Results: Four major themes emerged, namely roles of LPS, effects, sustainability and feasibility of PSOS. Overall PSOS was considered sustainable, feasible and had positive effects in and beyond the sub-districts. The value of PSOS was supported by improved access and timeliness of services, improved competency of RDH medical practitioners, improved coordination, comprehensiveness and continuity of care. Private specialist outreach and support was, however, associated with increased burden on the RDH resources and required a basic level of RDH infrastructure to function effectively. Conclusion: The perceived contribution of private specialist outreach services was positive overall. Implementation in RDHs is feasible, but should involve consideration of factors in the hospital, town, sub-district and district prior to implementation. Contribution: This paper provides evidence that private specialist outreach and support services are feasible in the state health sector, provided that certain considerations are taken into account. [ABSTRACT FROM AUTHOR]

Access to clean and functional toilet is quintessential in meeting children's physiological and psychosocial needs in a learning environment. However, little is known on experiences of children's access to quality toilets while in preschool institutions within urban settings of sub-Saharan Africa countries. This paper draws from a study that explored experiences of vulnerable children in early childhood development education (ECDE) institutions in underserved and informal urban settings of Kenya and South Africa. 11 urban ECDE centres were purposively selected and 17 teachers were recruited as key informants. Data was collected using an adapted infrastructural checklist, observation and conversational interviews. Findings indicated that a majority of toilets in ECDE centres were inadequate, inappropriate, poorly maintained, or had structural weaknesses which affected children's experiences of access and use of the facilities. Scheduled toilet visits as a control measure and toilet avoidance potentially exposed them to psychosocial and health risks. Insights into children's toilet facilities, managing their access in institutions located within informal and low resourced areas, and investment policies that target preschool children' sanitary facilities are given. Suggestions are made for interventions for children's positive toilet experiences in poor urban areas. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Several studies explore and describe the role of family dynamics in dementia care.However, few focus specifically on the diversity of family relationships that influence family caregivers' experiences of providing care to a relative with dementia.The role of family caregivers engaging in unpaid care of relatives with dementia is becoming more and more critical as the numbers of people living with dementia increase across the globe.Family caregivers are a diverse group of people as there are different categories of kinship relations and thus cannot be viewed as a single collective.They are linked intricately to their family and social support systems, however, they often experience limited family support, and tensions between family members can be a major source of stress.Hence, health professionals need to deepen their understanding of family relationships to enable them to provide effective advocacy and clinical support to family caregivers. What the paper adds to existing knowledge?: This study is unique in that it focuses on a range of family relationships in which a person with dementia finds themselves. It highlights that this network of complex connections influences the caregiving process.The study demonstrates the important role that siblings can play in sharing the caregiving load. However, this sharing is rarely balanced or fair and there is always someone in the family who carries the heaviest load.Communication between family members is frequently a challenge, with family members experiencing denial or an inability to understand the challenges encountered by the family caregiver.Most studies focus on the relationship between the family caregiver and the relative with dementia alone, rather than the family network of the family caregiver and how it influences the caregiving process.This study is unique as it focuses on family dynamics and the family network, particularly the range of family relationships in which family caregivers and their relative with dementia find themselves.Other studies tend to focus on a specific kinship category and the family network, such as an adult child, caring for their parent, but this study presents a wide variety of kinship categories to demonstrate the diversity of family caregiving contexts.The family caregivers in this study all highlighted the need or desire for effective support from the family network.Challenges of communication between family members and the caregiver were also evident and were framed within the existing family dynamic of each family. What are the implications for mental health nursing?: The findings suggest the need for communication (training and therapeutic) interventions between family caregivers and other family members (secondary caregivers). Mental health nurses are often well positioned to offer the family caregiver the option to undertake such an intervention.The findings emphasize the diversity of family caregiving situations and argue that mental health nurses can assess the nature of the care situations and work with families on how best to address the needs of the relative with dementia and the main caregiver.However, tensions frequently exist between family members, some of which existed prior to the relative acquiring dementia and other tensions as a consequence of the relative acquiring dementia. Mental health nurses could assist as a mediator between family members in order to assist families to become more cohesive. Introduction: This article explores the diverse nature of family caregivers, focusing on the different categories of kinship relations. Family caregivers are linked intricately to their families, but often experience limited family support, causing stress and tension between family members. Aim: The article aims to explore the family relationships of family members caring for relatives with dementia in order to provide an insight into the role of such relationships on the caregiver relative with dementia dyad. Method: A phenomenological, exploratory‐descriptive design was used. Eight participants took part and data were obtained using collages and semi‐structured interviews. Results: A range of family relationship patterns was highlighted including sibling involvement in the caregiving process; spousal involvement in supporting a caregiver of a parent; and spousal involvement in caring for their spouse. Discussion: The family caregivers highlighted the need or desire for effective support from the family network. Challenges of communication between family members and the caregiver were also evident and were framed within the existing family dynamic of each family. Implications for Practice: Mental health nurses need to deepen their understanding of family relationships to enable them to provide effective advocacy and clinical support to family caregivers and assist families to become more cohesive. [ABSTRACT FROM AUTHOR]

In this paper, we share some personal reflections of straddling different research roles in a doctoral study entitled Queering Sex Work and Mobility in South Africa. We highlight the importance of using a Feminist Participatory Action Research (FPAR) methodology when conducting studies with migrant and mobile sex workers as it offers participants an opportunity to express their lived realities and embodied knowledge(s) beyond linguistic barriers. Through our reflections, we demonstrate that marginalised communities can become co-creators in knowledge production processes, not just the givers of stories (aka 'poverty porn') but integral members of the research team who actively contribute towards the conceptualisation, data collection, analysis, publishing and distribution of scholarship. [ABSTRACT FROM AUTHOR]

COVID-19 has distorted the teaching and learning pedagogy, as well as the research process of higher education institutions, particularly in Africa. This pandemic-imposed restrictions on movement and demanded a shift to online interaction. This blurred the lines between work and home life and has exacerbated the deep chasms of inequality upon which South African society operates. Established on empirical evidence, substantiated by documentary data, this paper explores how these existing inequalities, exacerbated by COVID-19, manifest in the postgraduate research space of South African higher education institutions. Qualitative data were collected during a recorded focus group interview, and thematically analysed. Through a Neo-Weberian lens, it will illustrate that the pandemic, among other challenges, posed significant ethical challenges to honours students completing their research projects, in turn, shifting policies and requirements of higher education institutions (HEIs) themselves to ensure the protection of their students and quality of research output. These include concerns around digital exclusion, locating participant consent, as well as the collection of data via online channels (Zoom, WhatsApp, Skype) and their privacy parameters. Considering these gulfs of inequality, the paper recommends key requirements for the future of ethically sound research in higher education in South Africa. [ABSTRACT FROM AUTHOR]

In this paper, the author demonstrates that there is a range of primary sources on the Human Sciences Research Council (HSRC), South Africa's foremost non-teaching social science research body and its predecessor, the South African National Bureau for Educational and Social Research, lodged in the country's conventional and unconventional archives. The Central Records Department at Wits University is an example of the latter. Initially, scholars believed that the bulk of primary sources on the institution were not available. This has greatly affected the writing of the institution's history and as a result it remains largely undocumented. This paper demonstrates that raw material on the institution can be and has been located through systematic research in various depositories around South Africa. The paper gives an overview of materials on the institution lodged in different archives and describes typical examples. Such primary sources can greatly assist scholars with a research interest in the HSRC and its predecessor, the Bureau. [ABSTRACT FROM AUTHOR]

Background: Self-interviews, where the respondent rather than the interviewer enters answers to questions, have been proposed as a way to reduce social desirability bias associated with interviewer-led interviews. Computer-assisted self-interviews (CASI) are commonly proposed since the computer programme can guide respondents; however they require both language and computer literacy. We evaluated the feasibility and acceptability of using electronic methods to administer quantitative sexual behaviour questionnaires in the Somkhele demographic surveillance area (DSA) in rural KwaZulu-Natal, South Africa.Methods: We conducted a four-arm randomized trial of paper-and-pen-interview, computer-assisted personal-interview (CAPI), CASI and audio-CASI with an age-sex-urbanicity stratified sample of 504 adults resident in the DSA in 2015. We compared respondents' answers to their responses to the same questions in previous surveillance rounds. We also conducted 48 cognitive interviews, dual-coding responses using the Framework approach.Results: Three hundred forty (67%) individuals were interviewed and covariates and participation rates were balanced across arms. CASI and audio-CASI were significantly slower than interviewer-led interviews. Item non-response rates were higher in self-interview arms. In single-paper meta-analysis, self-interviewed individuals reported more socially undesirable sexual behaviours. Cognitive interviews found high acceptance of both self-interviews and the use of electronic methods, with some concerns that self-interview methods required more participant effort and literacy.Conclusions: Electronic data collection methods, including self-interview methods, proved feasible and acceptable for completing quantitative sexual behaviour questionnaires in a poor, rural South African setting. However, each method had both benefits and costs, and the choice of method should be based on context-specific criteria. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to explore how individuals living with multiple sclerosis experience their disorder in the South African working environment. In this paper we present the experiences of office-based workers living with multiple sclerosis, their challenges, and coping mechanisms. We purposively recruited seven participants who have been diagnosed with multiple sclerosis in the last five years. Participants were interviewed telephonically. Interviews were guided by a semi-structured interview schedule which was supplemented with additional probes. Interviews were analysed thematically using a qualitative software programme. We identified two superordinate themes: bringing multiple sclerosis into the workplace and adapting to multiple sclerosis in the workplace. The findings demonstrated the diverse manner in which participants chose to disclose their multiple sclerosis and manage co-workers' perceptions of multiple sclerosis. Participants employed practical strategies, such as making using of mobility aids, taking notes, conserving energy, and adapting responsibilities. Participants also negotiated accommodations, such as changing working hours, to overcome their unique challenges. Participants emphasised the importance of keeping a general positive attitude but showed reluctance to prepare for their future decline. Our findings indicate that participants manage the disclosure of their diagnosis of multiple sclerosis in order to maintain a favourable relationship with the workplace. Further, despite various physical and psychological limitations, participants were mostly able to adapt to their work environment. Although further research is required, employers and clinicians should consider focusing on the current needs of individuals living with multiple sclerosis to mitigate work-related challenges, rather than planning for future decline. For individuals living with multiple sclerosis and in employment in South Africa, disclosure, management of perceptions and providing accommodations are key aspects in the experience of multiple sclerosis in the workplace. Finding ways to help those in employment disclose their MS diagnosis to employers and co-workers, is an important avenue and next step for intervention research in this field. Early adjustment and adaptation to MS in the workplace is challenging and further negotiation with line-managers regarding accommodations is often required. Employers and clinicians should focus on accommodating the needs of those diagnosed with multiple sclerosis as they arise, rather than focusing solely on the accommodations needed in the future. [ABSTRACT FROM AUTHOR]

Objective: To determine if either prophylactic tramadol 50 mg or ibuprofen 400 mg/metoclopramide 10 mg result in lower maximal pain compared to placebo in women ≤63 days' gestation having a mifepristone-misoprostol medical abortion.Study Design: We conducted a randomized, placebo-controlled trial in Nepal, South Africa, and Vietnam. Participants seeking medical abortion received active treatment or placebo, taken at time of misoprostol and repeated 4 hours later. All had access to additional analgesia. The primary outcome was mean maximum pain score within 8 hours. Participants self-assessed maximum pain using an 11-point numeric rating scale recorded in paper diaries; we analyzed these data using intention-to-treat analysis. Secondary outcomes included use of additional analgesia, side effects, and satisfaction.Results: We enrolled 563 patients between June 2016 and October 2017; 5 participants failed to follow up. Mean adjusted maximum pain scores within 8 hours in both active arms were lower than placebo (tramadol: n = 188, 6.78 (95% confidence interval [CI] 6.46, 7.11); ibuprofen/metoclopramide: n = 187, 6.43 (95% CI 6.10, 6.75); placebo: n = 188, 7.42 (95% CI 7.10, 7.74); p = 0.0001). Additional analgesia was used by 97 (52.2%) participants in the tramadol group, 80 (43.0%) in the ibuprofen/metoclopramide group, and 103 (55.7%) in the placebo group, p = 0.04. More dizziness (p = 0.004), headache (p = 0.03), and vomiting (p < 0.001) occurred in the tramadol group. More participants reported experienced pain was the same or less than expected in the ibuprofen/metoclopramide group (p = 0.05); overall abortion satisfaction did not differ by group (p = 0.44).Conclusions: Compared with placebo, tramadol or ibuprofen/metoclopramide co-administered with misoprostol and repeated 4 h later resulted in lower mean maximum pain scores that failed to achieve clinical significance. Women who received ibuprofen/metoclopramide were least likely to use additional analgesia and reported fewer side effects.Implications: Given that tramadol, ibuprofen, and metoclopramide are inexpensive, globally available; and, ibuprofen and metoclopramide are included on the World Health Organization Essential Medicines List, these medicines could be considered for prophylactic pain management during medical abortion. [ABSTRACT FROM AUTHOR]

Child protection social workers (CPSWs) do critical work protecting vulnerable children. Given the demanding nature of this work, CPSWs are reportedly at great risk for negative outcomes, such as burnout and depression. Another outcome is often unsatisfactory service delivery by CPSWs, leaving vulnerable children exposed to continued maltreatment. Understanding how some CPSWs do well, despite the demanding nature of their work, is important to inform future interventions that could potentially promote CPSW resilience and improve CPSW service delivery. While some research on the resilience of CPSWs exists, very little is known about resilience in South African CPSWs. The aim of this qualitative study was to contribute to the ongoing conversation of CPSW resilience, by exploring resilience among CPSWs in Gauteng, South Africa. Participants shared their lived experiences of workplace adversity and resilience. In this paper, we report only on the findings related to their resilience, which was analysed using thematic analysis. Findings reveal that participants' resilience was informed by a safe and appealing space away from work; drawing strength from religion; relaxation and self‐care as healing modalities; a passion for CPSW; the positive influence of personal background; supportive care systems; self‐efficacy and personal agency; and a positive outlook. The resilience of these CPSWs, although dependent on supportive and responsive ecologies, was mostly self‐directed since they appeared fundamentally accountable to procure support. [ABSTRACT FROM AUTHOR]

Aim: To describe the trajectory of clinical signs in children who developed human immunodeficiency virus encephalopathy (HIVE) after starting early antiretroviral therapy (ART).Method: This was a retrospective case-cohort description of HIVE among Cape Town participants from the Children with HIV Early AntiRetroviral treatment (CHER) trial. Criteria for HIVE diagnosis were at least two of: (1) acquired central motor deficit, (2) impaired brain growth, and (3) failure to attain or loss of developmental milestones in the absence of an alternative aetiology.Results: Of 133 surviving participants who initiated ART at a median age of 9 weeks and who were followed until a median age of 6 years, 20 (12%) developed HIVE at a median age 31 months (interquartile range 19-37). In these, the first neurological deterioration was noticed at a median age of 19 months, when 16 were on ART and nine had undetectable HIV viral load for a median of 12 months. Signs of upper motor neurons were present in 18, of whom 12 resolved and four had persistent spastic diplegia; 19 had motor delay, of whom 14 resolved; 12 had language delay, of whom 11 resolved; and 16 had impaired brain growth, of whom only five recovered. For the 16 participants already on ART at HIVE diagnosis, regimens were not altered in response to diagnosis.Interpretation: HIVE may occur despite early ART initiation and virological suppression and then resolve on unchanged ART, most likely as intrathecal inflammation subsides.What This Paper Adds: Despite suppressive antiretroviral therapy, children can develop human immunodeficiency virus encephalopathy, The most common manifestations are motor deficits and impaired brain growth. Most experience improvement, with many resolving without additional intervention. [ABSTRACT FROM AUTHOR]

Informal settlements remain a public health problem as they lack basic infrastructure. Furthermore, it is challenging to enforce public health regulations and protocols to prevent the spread of infection during a pandemic. This paper was set out to explore the impact of lockdown during COVID-19 among people living in informal settlements. An exploratory qualitative design was utilised. Purposive sampling was used to select research participants. In-depth one-to-one interviews were held involving 30 research participants through a WhatsApp online telephone platform. A thematic approach underpinned by the four stages of data analysis in interpretive phenomenological analysis was utilised to analyse the data. The study found that during the the research participants were affected by lack of space to practice social distancing, over-burdened infrastructure, lack of savings, loss of income and shortage of food, hunger and diseases, anxiety and depression and poor access to education. There is a need to prioritise the needs of informal settlers and endeavour to establish permanent homes. Health promotion and communication initiatives and pandemic awareness programmes are needed to mitigate the impact of lockdown during a pandemic in informal settlements. [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]

Community engagement as a public mission of higher education is widely accepted in South Africa. This is articulated in White Paper 3 on the transformation of higher education and in institutional policies that promote different forms of community engagement. However, compared to the traditional roles of teaching and research, community engagement remains contested. It is most often viewed as voluntary and perhaps even peripheral. Given the serious social disparities in South Africa, community engagement needs to be invigorated and placed on par with the teaching and researching roles of universities. Furthermore, it should not only involve collaborative knowledge production, but should combine epistemological and ontological dimensions and involve holistic human development capable of dealing with social disparities A combined epistemological-ontological conception of community engagement is developed in this study and interventions are proposed at three levels. First, university induction programs, which tend to prioritize the teaching and researching roles of faculty members, should consider community engagement as equally important. Second, just as the teaching and researching roles tend to be well planned and/or incentivized, so too should community engagement. Third, community engagement should adopt a mode 2 knowledge production lens where community members reflexively produce knowledge together with faculty members and contribute to holistic human development. Finally, strategies are suggested to embed an epistemological-ontological conception of community engagement. [ABSTRACT FROM AUTHOR]

Background: Interventions targeting community health workers (CHWs) aim to optimise the delivery of health services to underserved rural areas. Whilst interventions are evaluated against their objectives, there remains limited evidence on the economic costs of these interventions, and the practicality and value of scale up. The aim of this paper is to undertake a cost analysis on a CHW training and supervision intervention using exclusive breastfeeding rates amongst mothers as an outcome measure.Methods: This is a retrospective cost analysis, from an implementer's perspective, of a cluster randomised controlled trial investigating the effectiveness of a continuous quality improvement (CQI) intervention aimed at CHWs providing care and support to pregnant women and women with babies aged < 1 year in South Africa.Results: One of the outcomes of the RCT revealed that the prevalence of exclusive breastfeeding (EBF) significantly improved, with the cost per mother EBF in the control and intervention arm calculated at US$760,13 and US$1705,28 respectively. The cost per additional mother practicing EBF was calculated to be US$7647, 88, with the supervision component of the intervention constituting 64% of the trial costs. In addition, women served by the intervention CHWs were more likely to have received a CHW visit and had significantly better knowledge of childcare practices.Conclusion: Whilst the cost of this intervention is high, adapted interventions could potentially offer an economical alternative for achieving selected maternal and child health (MCH) outcomes. The results of this study should inform future programmes aimed at providing adapted training and supervision to CHWs with the objective of improving community-level health outcomes. [ABSTRACT FROM AUTHOR]

The Intervention with Microfinance for AIDS and Gender Equity (IMAGE) programme has been scaled up to three provinces in South Africa. This paper explores associations between women's engagement in the intervention, intimate partner violence (IPV) and factors associated with IPV and partner abuse. We enrolled women receiving group-based microfinance loans plus gender training into the scaled-up IMAGE cohort study (n = 860). We present cross-sectional analysis on participants' characteristics and intervention engagement and use multivariate logistic regression to explore associations. 17% of women reported lifetime (95% CI 15 to 20%) and 7% past year (95% CI 5 to 9%) IPV, 9% past-year economic (95% CI 7 to 11%) and 11% past-year emotional (95% CI 9 to 14%) abuse. Women under 35 years had higher levels of IPV and emotional abuse. 53% of women attended all the trainings, 83% continuously borrowed and 98% agreed the training had a major impact on their life. Attendance was associated with improved partner relationships (χ2p < 0.001), but not lower IPV risk. Odds of past-year IPV decreased the more types of support (e.g. advice) women received from group members (aOR 0.27, p < 0.001 among those reporting all support versus none or some). A similar pattern was seen for economic, but not emotional, abuse. The scaled-up IMAGE intervention is widely acceptable and may support improvements in partner relationships, but younger women need to be targeted. Group support appears to be a potentially important component of the intervention. [ABSTRACT FROM AUTHOR]

Over the past decade, there has been increased focus on targeting couples in HIV prevention efforts, particularly in sub-Saharan Africa where HIV transmission primarily occurs through heterosexual contact, in the context of intersecting alcohol use and intimate partner violence (IPV). However, little is known about couples' general relationship functioning. This understanding is needed to augment couple-based HIV prevention programs and address risk for IPV. This paper presents data on domains of relationship functioning with 300 South African couples who were recruited for an HIV prevention study. Exploratory and confirmatory factor analyses were conducted to determine the relevance of 17 individual items, as well as the overall factor structure of the questions. Results revealed three independent factors of relationship functioning: relationship satisfaction, arguing, and open communication; an overarching construct of relationship functioning for these three domains was not observed in the data. Results provide insight into the structure of relationship functioning questions and subscales that can be used to assess South African adult romantic relationships. This may allow for a greater focus on aspects of relationships within couple-based HIV prevention programs going forward. [ABSTRACT FROM AUTHOR]

Giving credit to where it is due is common across cultures. In research, researchers widely express their gratitude to those who would have contributed to their studies in one way or the other under the acknowledgements section. In most cases, the selection of who to acknowledge remains the prerogative of the author. The purpose of this study was to review acknowledgements in Electronic Theses and Dissertations (ETDs) with a special focus on the acknowledgement accorded to the library and librarians at the North-West University in South Africa. This was done in order to determine the perceived value of librarians as partners in the research process by postgraduate students. The study followed a two pronged approach in which bibliometrics and survey research methods were used. In the case of the bibliometrics, ETDs completed between 2012 and 2018 were reviewed. Regarding the survey, both print and online questionnaires were used to gather data from postgraduate students. Excel spreadsheets and QuestionPro software were used to analyse the data. The study findings indicate that supervisors of research work topped the list of acknowledgees followed by family, friends and colleagues. The library/librarian acknowledgements, were among the least with only 15% of ETDs giving gratitude to the library/librarians. However, like in previous studies, it was observed that library/librarians were mentioned in other parts of the ETDs, apart from the acknowledgements section. The results further indicate that the majority of the surveyed participants, held acknowledgements in high esteem. The paper will go a long way in adding value to a body of existing literature which is largely from the developed world. It may also stimulate interest for related studies in other developing countries. [ABSTRACT FROM AUTHOR]

Traditional knowledge, especially with health-related issues, has become crucial across the world. This can be attributed to the assistance which humans and animals now require. In Africa, traditional healers have strived to offer health remedies through the support of plants with the aim of curing different ailments believed to have been either inherited or caused by attack from spiritual forces. This, to an ordinary person, is difficult to understand; hence the assistance and support of traditional healers play an important role in the treatment of health issues for many people, irrespective of the context. This is commonly referred to as "African traditional medicine" (ATM), being a holistic healthcare system that has attracted numerous researchers. Nonetheless, there is still a paucity of updated, comprehensive collation of research conducted across South Africa. The study that directed this article aimed to assess the publication trends on ATM between 1998 and 2018. The study used interpretive document analysis, where data were harvested from the Web of Science Citation Index Expanded. Findings indicate that 469 documents were retrieved from the database, and the majority of published papers were research articles. A downward trend in terms of the number of publications in 2018 was of concern, considering efforts that were made to encourage research in traditional medicine in South Africa. Results indicate that social sciences contributed the highest number of research publications, while the universities of KwaZulu-Natal, Witwatersrand and Pretoria were the top three contributors with the largest number of publications. The study recommends integrating traditional medicine into the curricula of all South African universities. [ABSTRACT FROM AUTHOR]

South Africa has increasing numbers of persons living with HIV on antiretroviral treatment (ART). There is evidence for a relationship between food, food security and HIV. Despite increasing rates of people older than 50 living with HIV coinciding with greater levels of co-morbidity, the existing research is largely limited to those aged 15–49 years. In this paper, we therefore explore how older people living with HIV (OPLWH) in two urban communities within South Africa negotiate and ensure they have sufficient access to food and how food insecurity may affect their retention in care and ART adherence. This study used exploratory qualitative semi-structured in-depth interviews with 23 OPLWH to collect data in isiXhosa. Data were analysed using thematic content analysis. Factors at the community, household and individual levels influence (a) access to sufficient and quality food, and (b) beliefs about ART and food based on (mis)understandings of messaging from health care providers. The results demonstrate the need to explore further and clarify the nutritional guidelines that OPLWH receive from providers to ensure this does not result in reduced adherence or retention in care. They also demonstrate the role that social welfare and family or kin obligations plays in ensuring the food security of OPLWH. [ABSTRACT FROM AUTHOR]

The HIV response is hampered by many obstacles to progression along the HIV care cascade, with men, in particular, experiencing different forms of disruption. One group of men, whose stories remain untold, are those who have succumbed to HIV-related illness. In this paper, we explore how next-of-kin account for the death of a male relative. We conducted 26 qualitative after-death interviews with family members of male PLHIV who had recently died from HIV in health and demographic surveillance sites in Malawi, Tanzania, Kenya, Uganda, Zimbabwe and South Africa. The next-of-kin expressed frustration about the defiance of their male relative to disclose his HIV status and ask for support, and attributed this to shame, fear and a lack of self-acceptance of HIV diagnosis. Next-of-kin painted a picture of their male relative as rebellious. Some claimed that their deceased relative deliberately ignored instructions received by the health worker. Others described their male relatives as unable to maintain caring relationships that would avail day-to-day treatment partners, and give purpose to their lives. Through these accounts, next-of-kin vocalised the perceived rebellious behaviour of these men, and in the process of doing so neutralised their responsibility for the premature death of their relative. [ABSTRACT FROM AUTHOR]

Objectives: There have been increasing calls for more research on interventions to successfully translate evidence-based knowledge into improved health policy and practices. This paper reports on an exploratory study of knowledge translation interventions conducted with participants of global health meetings held in Bangladesh in 2012 and in South Africa in 2013. We measured stakeholders' uptake of evidence-based knowledge in terms of their translation of this knowledge into actions around public health policy and practice. The research sought to determine whether participants shared and used knowledge from the meetings to improve health policy and practices in their settings and the factors influencing sharing and use. Study design: An exploratory study employed quantitative and qualitative methods of online surveys and in-depth interviews to collect data from all meeting participants. Methods: All participants in the Bangladesh and South Africa meetings were invited to complete an online survey during the meetings and over the following six weeks. Of 411 participants in the 2012 Bangladesh meeting, 148 participants from 22 countries completed the survey. Eleven of these respondents (from eight countries) were interviewed. Of the 436 participants in the 2013 South Africa meeting, 126 respondents from 33 countries completed an online survey; none of these respondents were interviewed. Results: The analysis revealed that most respondents used new knowledge to advocate for policy change (2012: 65.5%; 2013: 67.5%) or improve service quality (2012: 60.1%; 2013: 70.6%). The type of knowledge that respondents most commonly shared was clinical or scientific information (2012: 79.1%; 2013: 66.7%) and country-specific information (2012: 73.0%; 2013: 71.4%). Most 2012 respondents shared knowledge because they thought it would be useful to a co-worker or colleague (79.7%). Discussion: Findings on knowledge use and sharing suggest that most respondents saw themselves as knowledge brokers or intermediaries in a position to influence the translation of knowledge into action in health policy and practices in their countries. Results suggest that supporting knowledge brokers working in a local and regional context to spur change, as described in the paper, has the potential to improve health outcomes. Further research is needed to isolate specific interventions and their knowledge translation outcomes. [ABSTRACT FROM AUTHOR]

This paper examines the socially engaged art project Nine Urban Biotopes (9UB), an international exchange between European and South African cultural organisations. Two artist residencies offer case studies of collaborative arts and research practice. The ways that these case studies are read as 'failures' and 'successes' illustrate the complexities of North-South collaborations. This project, the partnership that sustained it and the residencies that were central to it, exemplify, in modest ways, how public sociology can be realised in modest ways in a global context. This paper shows, with examples, that whilst partnership and collaboration are emphasised in institutional and policy discourse, in practice these arrangements are filled with tension and unequal power relations between partners. An evaluative methodology premised on sociological practice allows the tensions that are inherent in partnership and collaboration to be recognised and productively interrogated. It also allows us to reimagine what 'success' and 'failure' looks like in research partnerships by working with the antagonisms that are integral to collaboration. [ABSTRACT FROM AUTHOR]

In urban informal areas of South Africa, obesity and hunger represent two sides of food insecurity. Despite this, public health and clinical obesity interventions focus on nutrition education, implying dietary choice and thereby overlooking food insecurity. The objective of this paper is to explore peri-urban residents' perspectives of changing food environments, framed by the Food Aid Organization (FAO) definition of food security and demonstrating the interconnectedness of dimensions of food security. We conducted three-part in-depth interviews with 21 participants and nine focus group discussions with a total of 57 participants, consisting primarily of women aged 20-84, in a peri-urban township and informal settlement outside of Cape Town, South Africa. Participants' encounters in clinical settings framed choice as a driver of diet-related non-communicable disease (NCD). Yet participants lacked economic access to food, particularly at the end of the month. Diets consisted of fewer green leafy vegetables relative to their diets in rural areas, despite affirming a preference for these foods. They described consuming more meat, which was also perceived as unhealthy. Based on self-report, residents within this peri-urban area of South Africa were food insecure: they lacked access to food at specific times of the month, they were unable to consume foods they preferred, and they felt that their diets were neither nutritious nor enabled an active and healthy life. When viewed in terms of multiple facets of food security, participants' concurrent experiences of hunger and obesity were unsurprising. Health interventions related to diet should incorporate an understanding of food security as shaped by the interactions of access, availability, utilization and stability. [ABSTRACT FROM AUTHOR]

The effects of HIV and AIDS have devastated families and communities in South Africa. The scourge has also left many children orphaned in the country. Given the vulnerability of orphaned children, social workers are in the forefront of ensuring that these children are cared for and protected from any harm. Hence, the purpose of this paper was to explore the role of a social worker in issues related to children orphaned by AIDS in their middle childhood. This study was situated within a qualitative research paradigm utilizing purposive, non-probability sampling of 10 participants recruited from Potchefstroom in the Northwest Province of South Africa. A semi-structured interview schedule was employed as a research tool, and in-depth one-on-one interviews were adopted as the method of data collection. A thematic content analysis was used to analyze the data collected during the interviews. The main findings point towards the need to educate children about HIV and AIDS and to empower their caregivers. The primary conclusion drawn from this study is that social workers play various key roles which contribute towards the well-being of orphaned children. Recommendations are posed in relation to social work service providers, government interventions, and future research. [ABSTRACT FROM AUTHOR]

For many African countries, the structure of the economy is still tilted towards agriculture and agro-allied industries. In recent times, investment in agriculture is being championed as one of the key routes to bolstering African economies, providing jobs for the burgeoning youthful population, and lifting many Africans out of poverty. However, the form of agriculture that will deliver these lofty goals (ambitious outcomes) cannot rely on the typical way agriculture has been, and is being practised, in many parts of Africa. It will have to draw heavily on locally relevant, sound science based, and well adopted agricultural research and innovations, tailored to African contexts. In this paper, drawing from the outputs of a foresight workshop by African agricultural experts, we explored the plausible futures of agricultural research and innovations in Africa. In the end, four future scenarios of African agricultural research and innovations derived from the combination of dominant drivers as conceived by African experts are presented. [ABSTRACT FROM AUTHOR]

Introduction: The South African National Department of Health sought to improve syndromic management of sexually transmitted infections (STIs). Continuing medical education on STIs was delivered at primary healthcare (PHC) clinics using one of three training methods: (1) lecture, (2) computer and (3) paper-based. Clinics with training were compared with control clinics.Methods: Ten PHC clinics were randomly assigned to control and 10 to each training method arm. Clinicians participated in on-site training on six modules; two per week for three weeks. Each clinic was visited by three or four unannounced standardised patient (SP) actors pre-training and post-training. Male SPs reported symptoms of male urethritis syndrome and female SPs reported symptoms of vaginal discharge syndrome. Quality of healthcare was measured by whether or not clinicians completed five tasks: HIV test, genital exam, correct medications, condoms and partner notification.Results: An average of 31% of clinicians from each PHC attended each module. Quality of STI care was low. Pre-training (n=128) clinicians completed an average of 1.63 tasks. Post-training (n=114) they completed 1.73. There was no change in the number of STI tasks completed in the control arm and an 11% increase overall in the training arms relative to the control (ratio of relative risk (RRR)=1.11, 95% CI 0.67 to 1.84). Across training arms, there was a 26% increase (RRR=1.26, 95% CI 0.77 to 2.06) associated with lecture, 17% increase (RRR=1.17, 95% CI 0.59 to 2.28) with paper-based and 13% decrease (RRR=0.87, 95% CI 0.40 to 1.90) with computer arm relative to the control.Conclusions: Future interventions should address increasing training attendance and computer-based training effectiveness.Trial Registration Number: AEARCTR-0000668. [ABSTRACT FROM AUTHOR]

The teaching-research 'nexus' has been an area of historic and ongoing controversy within universities and discussions into the nexus between teaching and research continues to expand. Within the accounting discipline, where new knowledge is perceived to be located 'outside' the university, academics struggle to describe and evaluate their roles as teachers and researchers. This paper investigates the perceptions of accounting academics and professional accountants in South Africa with regards to the meaning of research, their role as teachers, and the nexus between teaching and research. This study suggests that the external production and application of specialised knowledge in accounting, the strong control by the profession of the accounting curriculum offered by accredited universities, and their loyalty towards the profession, obstruct the perceived research role and value of accounting academics. Accounting academics and universities are encouraged to break away from the simple categories of 'research-teaching' and accept the multi-faceted understanding of academic work within a professional programme, as demonstrated in the paper. [ABSTRACT FROM AUTHOR]

Research data management (RDM) and its accompanying services and infrastructures are predominantly still in a state of infancy in many African countries and little is known about the RDM habits of the researchers from these areas. Our research showed that researcher RDM behaviour is similar across the globe, but our experience was that the will to implement formal RDM is not. Similarly, the responsibility for RDM implementation is not always clear. What is clear is that, although the library should not assume primary responsibility, it does have a role to play in the successful implementation of RDM services. This paper briefly discusses the results of two RDM surveys conducted at a relatively resource-constrained, albeit leading, South African research institute. The surveys were designed to establish the RDM habits as well as the RDM needs as expressed by both emerging and experienced researchers at the stated institute. The intention was to use the results to initiate full-scale implementation of RDM services by the library. It was interesting to note that neither the emerging nor the experienced researchers showed significant deviations in research behaviour compared to that found amongst their colleagues in more well-resourced environments. What was different is that implementation grinded to a halt and that an action plan that deviated from that in published literature had to be developed so that relevant progress could still be made. This RDM action plan includes a range of stakeholders and would be of use to research institutes starting out on the RDM journey. [ABSTRACT FROM AUTHOR]

Background: In South Africa, HIV is increasingly becoming a chronic disease as a result of advances in HIV treatment and prevention in the last three decades. This has changed the perception from a life threating to a potentially manageable disease. However, little is known about self-perceived health status of HIV-infected individuals. Self-rated health (SRH) has been shown to be a sensitive indicator of health-relatedchanges directly linked to HIV, but can also be influenced by differences in social and material conditions. The aim of this paper was to identify determinants of excellent/good SRH among HIV-infected individuals using socio-demographic, life style and health related data.Methods: The study used data from the nationally representative 2012 South African population-based household survey on HIV prevalence, incidence and behaviour conducted using multi-stage stratified cluster sampling design. Bivariate and multivariate logistic regression models were used to identify determinants of SRH among HIV-infected individuals.Results: Out of a total of 2632 HIV positive participants 74.1% (95% CI: 68.4-74.2) reported excellent/good SRH. Increased likelihood of reporting excellent/good SRH was significantly associated with being Black African [OR= 1.97 (95%CI: 1.12-3.46), p = 0.019] and belonging to least poor household [OR= 3.13 (95%CI: 1.26-7.78), p = 0.014]. Decreased likelihood of reporting excellent/good SRH was significantly associated with those aged 25 to 34 years [OR= 0.49 (95% CI: 0.31-0.78), p = 0.003], 35 to 44 years[OR= 0.27 (95% CI: 0.17-0.44), p < 0.001], 45 to 54 years [OR= 0.20 (95% CI: 0.12-0.34), p < 0.001], and those 55 years and older [OR= 0.15 (95% CI: 0.09-0.26), p < 0.001], hospitalization in the past twelve months [OR= 0.40 (95% CI: 0.26-0.60), p < 0.001].Conclusion: To have positive health effects and improve the perceived health status for PLWH social interventions should seek to enhance to support for the elderly HIV-positive individuals, and address the challenge of socio-economic inequalities and underlying comorbid conditions resulting in hospitalization. [ABSTRACT FROM AUTHOR]

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]

Research on prejudice seeks to understand and transform inaccurate beliefs about others. Indeed, historically such research has offered a cautionary tale of the biased nature of human cognition. Recently, however, this view has been challenged by work defending the essential rationality of intergroup perception, a theme captured controversially in Jussim and colleagues' (2009) research on the 'unbearable accuracy of stereotyping'. The present paper argues that in its own terms the 'rationalist turn' in socio-cognitive research on stereotyping presents an important challenge to the prejudice tradition, raising troubling questions about its conceptual and empirical foundations. However, it also argues for the necessity of transcending those terms. By focusing on the correspondence between individual beliefs and the supposedly 'objective' characteristics of others, we neglect the historical and discursive practices through which the social realities that we 'perceive' are actively constructed and institutionalized. We mask their social origins, contested and perspectival nature, relativity, and relationship to wider structures of power. By implication, moving beyond the Allportian perspective that has dominated both the prejudice tradition and the emerging stereotype accuracy paradigm, we may now need to prioritize other kinds of questions. Reversing Allport's famous definition of prejudice, it may now be time to ask: How, and with what consequences, does 'thinking ill of others' become sufficiently warranted? How does such thinking become part of institutionalized relations of power and an accepted way of perceiving, evaluating and treating others? What should social psychologists be doing to challenge this state of affairs? [ABSTRACT FROM AUTHOR]

Although anti-retroviral treatments have significantly reduced the incidence of mother-to-child transmission of HIV and AIDS, there remains, for the foreseeable future, a group of adolescents who have been perinatally infected. Noting the paucity of information regarding the impact of paediatric AIDS and its intersection with residential care, this paper investigates the lived realities of 20 South African adolescents who were vertically infected with HIV and AIDS, were abandoned, and have been raised in residential care. The exploratory study highlights that for these youth the dimensions of their adolescence, HIV-positive status and associated abandonment as well as life in residential care are mutually reinforcing and interconnected. Issues of race and class also interact with these social dimensions. Ultimately, these dimensions intersect to create a particular form of social exclusion. Intentional, critical intervention is required on the micro level to support these teens develop a coherent identity. On the meso level, the residential facility should actively facilitate community integration, particularly with the adolescents’ communities (and where possible, families) of origin. Governments need to strengthen intersectoral, rights-based responses and in particular, address the consequences of cognitive impairment associated with perinatal transmission. [ABSTRACT FROM AUTHOR]

The Open Science (OS) movement promises nothing less than a revolution in the availability of scientific knowledge around the globe. By removing barriers to online data and encouraging publication in Open Access formats and Open Data archives, OS seeks to expand the role, reach and value of research. The promises of OS imply a set of expectations about what different publics hope to gain from research, how accountability and participation can be enhanced, and what makes science public in the first place. This paper presents empirical material from fieldwork undertaken in (bio)chemistry laboratories in Kenya and South Africa to examine the extent to which these ideals can be realized in a sub-Saharan context. To analyse the challenges African researchers face in making use of freely available data, we draw from Amartya Sen’s Capabilities Approach. His theorisations of ‘conversion factors’ helps to understand how seemingly minor economic and social contingencies can hamper the production and (re-)use of online data. In contrast to initiatives that seek to make more data available, we suggest the need to facilitate a more egalitarian engagement with online data resources. [ABSTRACT FROM PUBLISHER]

Nurses experience high levels of work related stress and burnout as well as low job satisfaction and poor general health owing to the nature of their work. This paper seeks to provide a better understanding of the nature of relationships between work related stress, burnout, job satisfaction and general health of nurses over one year. This study involved a longitudinal design. Two hundred and seventy seven nurses from four hospitals completed a follow up survey consisting of five questionnaires. Data were collected between 2013 and 2014. The data were analysed using generalized estimation equation analysis. Lack of support was associated with burnout, patient care was associated with job satisfaction and staff issues were associated with general health of nurses. Burnout is more strongly related to job satisfaction than general health. The findings of this study could inform evidence based policy and practice through interventions aimed at improving job satisfaction and reducing the impact of burnout on general health of nurses. [ABSTRACT FROM AUTHOR]

In order to achieve optimal benefits of antiretroviral therapy (ART), caregivers of children receiving ART are required to attend routine clinic visits monthly and administer medication to the child as prescribed. Yet, the level of adherence to these behaviours varies considerably in many settings. As a way to achieve optimal adherence in rural KwaZulu-Natal, caregivers are required to attend routine counselling sessions at HIV treatment clinics that are centred on imparting information, motivation, and behavioural skills related to medication administration. According to the information-motivation-behavioural skills model, information related to adherence, motivation, and behavioural skills are necessary and fundamental determinants of adherence to ART. The purpose of the study was to observe and document the content of adherence counselling sessions that caregivers attending rural clinics in KwaZulu Natal receive. We observed 25 adherence counselling sessions, which lasted on average 8.1 minutes. Counselling typically consisted of counsellors recording patient attendance, reporting CD4 count and viral load results to caregivers, emphasising dose times, and asking caregivers to name their medications and dosage amounts. Patients were seldom asked to demonstrate how they measure the medication. They were also not probed for problems regarding treatment, even when an unsuppressed VL was reported to a caregiver. This paper calls attention to the sub-optimal level of counselling provided to patients on ART and the urgent need to standardise and improve the training, support, and debriefing provided to counsellors. [ABSTRACT FROM PUBLISHER]

Background This paper reports part of the findings of a study which exposed sexual violence in schools for learners with mild intellectual disability in South Africa. Special attention was paid on factors contributing to such a problem. Methods Data were collected using focus groups and individual interviews with 16 learners with mild intellectual disability at two special schools in South Africa. This was followed by individual interviews with the school nurse and social worker, and an analysis of schools' books of incidents. Results Factors contributing to sexual violence at schools for learners with mild intellectual disability included: (i) peer pressure, (ii) concealment of reported incidents of sexual violence, (iii) unsupervised areas linked to schools and (iv) arranged relationships. Conclusion The following suggestions are put forth: (i) awareness programmes, (ii) sensitization of teachers about the consequences and prevention of sexual violence, (iii) boundaries within which the arranged relationship occurs, (iv) intensification of sexuality education and (v) supervision around the school premises. [ABSTRACT FROM AUTHOR]

Objective: Cash transfer programmes targeting children are considered an effective strategy for addressing child poverty and for improving child health outcomes in developing countries. In South Africa, the Child Support Grant (CSG) is the largest cash transfer programme targeting children from poor households. The present paper investigates the association of the duration of CSG receipt with child growth at 2 years in three diverse areas of South Africa.Design: The study analysed data on CSG receipt and anthropometric measurements from children. Predictors of stunting were assessed using a backward regression model.Setting: Paarl (peri-urban), Rietvlei (rural) and Umlazi (urban township), South Africa, 2008.Subjects: Children (n 746), median age 22 months.Results: High rates of stunting were observed in Umlazi (28 %), Rietvlei (20 %) and Paarl (17 %). Duration of CSG receipt had no effect on stunting. HIV exposure (adjusted OR=2·30; 95 % CI 1·31, 4·03) and low birth weight (adjusted=OR 2·01, 95 % CI 1·02, 3·96) were associated with stunting, and maternal education had a protective effect on stunting.Conclusions: Our findings suggest that, despite the presence of the CSG, high rates of stunting among poor children continue unabated in South Africa. We argue that the effect of the CSG on nutritional status may have been eroded by food price inflation and limited progress in the provision of other important interventions and social services. [ABSTRACT FROM AUTHOR]

Background: A hybrid performance measurement system that combines patient-reported outcome data with administrative data has been developed for South African substance abuse treatment services. This paper describes the development and psychometric validation of one component of this system, the South African Addiction Treatment Services Assessment (SAATSA).Methods: First, a national steering committee identified five domains and corresponding indicators on which treatment quality should be assessed. A decision was made to develop a patient survey to assess several of these indicators. A stakeholder work group sourced survey items and generated additional items where appropriate. The feasibility and face validity of these items were examined during cognitive response testing with 16 patients. This led to the elimination of several items. Next, we conducted an initial psychometric validation of the SAATSA with 364 patients from residential and outpatient services. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted to assess the latent structure of the SAATSA. Findings highlighted areas where the SAATSA required revision. Following revision, we conducted another psychometric validation with an additional sample of 285 patients. We used EFA and CFA to assess construct validity and we assessed reliability using Cronbach's measure of internal consistency.Results: The final version of the SAATSA comprised 31 items (rated on a four-point response scale) that correspond to six scales. Four of these scales are patient-reported outcome measures (substance use, quality of life, social connectedness and HIV risk outcomes) that together assess the perceived effectiveness of treatment. The remaining two scales assess patients' perceptions of access to and quality of care. The models for the final revised scales had good fit and the internal reliability of these scales was good to excellent, with Cronbach's α ranging from 0.72 to 0.89.Conclusion: A lack of adequate measurement tools hampers efforts to improve the quality of substance abuse treatment. Our preliminary evidence suggests that the SAATSA, a novel patient survey that assesses patients' perceptions of the outcomes and quality of substance abuse treatment, is a psychometrically robust tool that can help fill this void. [ABSTRACT FROM AUTHOR]

Background Migrating nursing labour inadvertently reinforces South Africa's care drain, contributes to a global care crisis and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge. Method An exploratory descriptive-interpretivist method investigated nurses' experiences of psychiatric intellectual disability work. Sixteen free association narrative interviews were collected in 2013. Thematic analysis allowed findings to emerge from the data. Results Findings reflect a number of themes: 'relational interaction', 'care burden', 'system fatigue', 'infantilising dynamic of care' and 'resources for coping'. Conclusion System fatigue contributes more to negative experiences of providing care than direct patient work, and nurses experience more relational reciprocity from patients than from institutional management. Organizations should meet nurses' needs for burnout prevention, afford them impact in implementing institutional controls, and engage in a non-exploitative and non-exclusionary way. [ABSTRACT FROM AUTHOR]

While much research has documented unsatisfactory sexual and reproductive health (SRH) awareness among young people in South Africa, understanding of gender differences in access to and evaluation of SRH information is limited. This paper concerned itself with men and women's informal sources and content of SRH, and gendered divergences around accessibility, evaluation, and impact of such information. Fifty sexual history narrative interviews and twenty-five narrative interviews with women were conducted with participants purposively sampled from a range of ages, cultural and racial backgrounds, and in urban and rural sites across five provinces in South Africa. Data were analysed using thematic analysis. While young women were more likely to learn about SRH information from family members, they also reported greater regulation concerning their sexuality. This could enhance stigma surrounding women's sexuality and hinder open communication. Men predominantly learned about sex through pornography and peers, which was reported to encourage sexual prowess to the neglect of practising safer sex. Lack of adequate SRH instruction for young people as revealed through the narratives had significant and often negative implications for men and women's early safer sex behaviours. In response to these insights, recommendations are offered to strengthen informal sources of SRH awareness. [ABSTRACT FROM AUTHOR]

In several studies of antiretroviral treatment (ART) programs for persons with human immunodeficiency virus infection, investigators have reported that there has been a higher rate of loss to follow-up (LTFU) among patients initiating ART in recent years than among patients who initiated ART during earlier time periods. This finding is frequently interpreted as reflecting deterioration of patient retention in the face of increasing patient loads. However, in this paper we demonstrate by simulation that transient gaps in follow-up could lead to bias when standard survival analysis techniques are applied. We created a simulated cohort of patients with different dates of ART initiation. Rates of ART interruption, ART resumption, and mortality were assumed to remain constant over time, but when we applied a standard definition of LTFU, the simulated probability of being classified LTFU at a particular ART duration was substantially higher in recently enrolled cohorts. This suggests that much of the apparent trend towards increased LTFU may be attributed to bias caused by transient interruptions in care. Alternative statistical techniques need to be used when analyzing predictors of LTFU—for example, using “prospective” definitions of LTFU in place of “retrospective” definitions. Similar considerations may apply when analyzing predictors of LTFU from treatment programs for other chronic diseases. [ABSTRACT FROM PUBLISHER]

Aims This paper describes the perceptions of nurse managers about their dual role in nursing units as cost centres. Background The tertiary hospital in the Limpopo province is the first institution to appoint nurse managers with a dual role in cost centres. The development of a conceptual framework for a context-specific programme for Cost Centre Managers is the first of its nature in South Africa. Method A qualitative, exploratory, descriptive design was followed. The target population included nurse managers ( n = 35) formally appointed as cost centre managers with a dual role of delivering quality care and cost management. A focus group and individual interviews were conducted until data saturation occurred. Results Personal and professional distress, an empowering potential of being a cost centre manager, and the need for decentralized cost centre management were indicated as barriers for nurse managers that led to a framework for a context-specific training programme. Conclusion There is a need for a context-specific training programme for cost centre managers in a hospital with cost centres. Implications for nursing management The training of cost centre managers for their dual role in cost centres could enhance cost effectiveness, quality care and staff satisfaction. [ABSTRACT FROM AUTHOR]

Social work students deal with complex social problems such as poverty, unemployment and the devastating effects of HIV and AIDS in their practice, education and training and it is important to acknowledge that these developmental challenges have global dimensions. The four foundational pillars in the Global Agenda on Social Work and Social Development provide a framework for social work policy education. A project using this framework was implemented in South Africa and the United States. This article discusses the findings of an exploratory qualitative research project based on 58 student final papers from South Africa. [ABSTRACT FROM PUBLISHER]

Introduction: South Africa has seen a sharp increase in treatment admission trends for opioids despite beliefs that rates of opioid use remain low and do not represent a major problem. To advocate for the extension of Opioid Use Disorder (OUD) treatment and harm minimisation services in South Africa, better estimates of the extent of opioid use is needed. This paper responds to this need by describing (i) trends in treatment utilization for opioid-related problems in South Africa and (ii) differences in the profile of patients accessing treatment for different classes of opioids - heroin, 'nyaope' and codeine use.Methods: Data were collected from 83 specialist treatment centres participating in the South African Community Epidemiology Network on Drug Use between 2012 and 2017. Descriptive analyses were conducted to describe the sociodemographic profile of patients and multiple logistic regression was used to explore socio-demographic and clinical factors associated with admission to treatment for opioid use disorders (OUD) .Results: From January 2012 to December 2017, data from 11 2032 treatment episodes were collated. Of these, 20 319 (18.1%) were from patients admitted for an OUD. Over time, the proportion of overall opioid-related admissions increased significantly from 16.1% of all admissions in 2012 to 20.0% in 2017 (p <0.001). Data also suggests a significant increase in the overall proportion of patients reporting injection drug use, from 1.6% in 2013 to 3.5% in 2017 (p <0.001). Clear differences in employment status, referral sources between classes of opioids were also noted.Conclusion: Over the last 5 years, South Africa has seen an increase in the proportion of opioid related disorders (OUD) treatment admissions. Public health interventions, evidence-based harm reduction approaches and improving access to treatment are among the interventions urgently needed to reduce the harms associated with the increased use of opioids in South Africa. [ABSTRACT FROM AUTHOR]