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The purpose of this position paper by the South African Academy of Family Physicians (SAAFPs) is to inform decision making on human resources for health policy in South Africa and the placement of family physicians (FPs) in the district health system. National policies have been marred by misunderstanding of the roles and contribution of FPs; and there is unhelpful variability in how FPs are positioned in the health services between provinces. In the private sector, medical aid schemes have discriminated against FPs by failing to remunerate them as specialists and to recognise their scope of practice. [ABSTRACT FROM AUTHOR]

Background: Basic palliative care teaching should be included in training curricula for health care providers (HCPs) at all levels of the health service to ensure that the goal set by the South African (SA) National Policy Framework and Strategy for Palliative Care, to have an adequate number of appropriately trained HCPs in South Africa, is achieved. Furthermore, palliative learning objectives for nurses and doctors should be standardised. Many SA medical schools have integrated elements of Palliative Medicine (PM) teaching into undergraduate medical training programmes for doctors; however, the degree of integration varies widely, and consensus and standardisation of the content, structure and delivery of such PM training programmes are not yet a reality. Aim: This joint position paper aims to describe the current state of undergraduate medical PM teaching in South Africa and define the PM competencies required for an SA generalist doctor. Setting: Palliative Medicine programme leads and teachers from eight medical schools in South Africa. Methods: A survey exploring the structure, organisation and content of the respective medical undergraduate PM programmes was distributed to PM programme leads and teachers. Results: Responses were received from seven medical schools. Through a process of iterative review, competencies were defined and further grouped according to suitability for the preclinical and clinical components of the curriculum. Conclusion: Through mapping out these competencies in a spiralled medical curriculum, the authors hope to provide guidance to medical curriculum designers to effectively integrate PM teaching and learning into current curricula in line with the goals of the SA National Policy Framework and Strategy on Palliative Care (NPFSPC). [ABSTRACT FROM AUTHOR]

Background: Literature shows that in South Africa there are insufficient resources to meet mental healthcare needs. At general or district hospital level, the non-specialist doctor is often responsible for the holistic assessment and management of mental health service users. Such situations inevitably increase doctors' care load as they are required to treat across disciplines. We highlight the particular challenges faced by a community service (CS) doctor in this context. Methods: The presented case study formed part of a larger project that investigated public mental healthcare provision in the Eastern Cape province. Data were collected through a once-off semi-structured interview with the participant. The interview was transcribed and data analysed by utilising thematic analysis to yield results. Results: The study suggests that the CS doctor experiences being overloaded with duties, and feels overwhelmed in a healthcare context that lacks resources needed for service provision, which may lead to inadequate mental healthcare provision to public health service users. Conclusion: Healthcare facilities in rural parts of the Eastern Cape province are in need of assistance. This in-depth account highlighted the consequences of working on the front line of a disadvantaged and under-resourced health system. The presented account can be interpreted as a cry for help by CS doctors for relevant authorities to improve access and provision of mental healthcare in the area. Contribution: The paper provides an exploration of the circumstances wherein mental healthcare is provided in rural parts of South Africa. [ABSTRACT FROM AUTHOR]

Background: There has been a steady increase in the number of students with disabilities (SWD) in Higher Education Institutions (HEIs) in South Africa, with a significant number of students having visual disabilities. Equal access remains a key challenge in the classroom setting, thus emphasising a significant gap. Objectives: This paper capitalised on the significance of this gap and examined the potential of Universal Design of Instruction (UDI) to promote equal access for students with visual disabilities (SWVDs) in the classroom within a university setting in order to maximise learning outcomes. Method: The study was conducted at the University of KwaZulu-Natal (UKZN), which had approximately 204 SWVDs. This paper draws primarily on the quantitative component of the study. Data collection entailed distributing a questionnaire to all SWVDs. Analysis was conducted using SPSS 21, which produced descriptive and inferential statistics. The theoretical framework of Sen's Capability Approach in line with the Social Model of Disability was applied. Results: Findings indicated a lack of UDI in the classroom with very little compliance to all principles, resulting in increased challenges in teaching and learning for SWVDs. The incorporation of UDI in the classroom does have a positive correlation with learning outcomes. Conclusion: The incorporation of UDI principles can offer a potential design for easier access to teaching and learning to enhance and maximise learning outcomes; alleviate access challenges in the classroom; and address the negative experiences thereof for SWVDs. Contribution: The study adds value to the scarce body of knowledge on UDI in the classroom for university SWVDs from a learning enhancement perspective. [ABSTRACT FROM AUTHOR]

Muslims constitute approximately 20% of the world's population. In South Africa, Muslims constitute just under 2% of the total population. Fasting is one of the mandatory activities of adherents of the Islamic faith, where all healthy adult Muslims abstain from food, drink, and sexual activities between dawn and dusk during the month of Ramadhan. Medical doctors are frequently required to provide advice to their Muslim patients about the safety or other health impacts of this type of fasting. This narrative review provides an overview of research conducted on Muslim populations during the fasting period, with special reference to non-communicable diseases (NCDs) that are prevalent in the Muslim community. In the absence of evidence-based clinical guidelines, this article summarises the latest published research on this topic, providing a resource for clinicians and researchers. This paper provides an evidence summary to clinicians when engaging with their patients who may be engaging in Ramadhan fasting, while also identifying gaps in the body of evidence that could inform future research. [ABSTRACT FROM AUTHOR]

Background: Participation in activities of daily living (ADL), education, leisure and play in children living with cerebral palsy (CP) may be affected by various factors, as outlined in the International Classification of Functioning, Disability and Health Framework (ICF). The aim of this study was to describe the participation patterns of a group of these children. Objectives: This study aimed to describe participation patterns in ADL, education, leisure and play activities of children living with CP in Modimolle. Method: An exploratory-descriptive qualitative (EDQ) study design was used. A researcher-constructed bio-demographic data sheet and a semi-structured interview schedule were used to collect data from the primary caregivers of children (5–17 years) living with CP in Modimolle. Interviews were transcribed verbatim, translated from Sepedi to English and analysed using the content analysis approach and NVivo software. Results: The findings of this study indicated that children living with CP in Modimolle require set-up and assistance to participate in various ADL such as self-care, family and community activities. They also participate in formal and informal educational programmes as well as active and passive leisure and play activities. However, at the moment, they have limited opportunities to participate because of resource constraints and inaccessible infrastructure. Conclusion: Although children with CP in Modimolle perform some ADL, and participate in educational, leisure and play activities, they are not fully integrated into their community. Legislative support and policy implementation are required to improve participation and integration of children living with CP. Further studies on community-specific integrative strategies to enhance participation among children living with disabilities are recommended. Contribution: This paper provides valuable information on the participation patterns of children with CP living in a rural area of South Africa. The findings can assist with development and implementation of community-specific, integrative health and social care strategies to enhance participation among children living with disabilities. [ABSTRACT FROM AUTHOR]

Background: There has been a steady increase in the number of students with disabilities (SWD) in Higher Education Institutions (HEIs) in South Africa, with a significant number of students having visual disabilities. Equal access remains a key challenge in the classroom setting, thus emphasising a significant gap. Objectives: This paper capitalised on the significance of this gap and examined the potential of Universal Design of Instruction (UDI) to promote equal access for students with visual disabilities (SWVDs) in the classroom within a university setting in order to maximise learning outcomes. Method: The study was conducted at the University of KwaZulu-Natal (UKZN), which had approximately 204 SWVDs. This paper draws primarily on the quantitative component of the study. Data collection entailed distributing a questionnaire to all SWVDs. Analysis was conducted using SPSS 21, which produced descriptive and inferential statistics. The theoretical framework of Sen's Capability Approach in line with the Social Model of Disability was applied. Results: Findings indicated a lack of UDI in the classroom with very little compliance to all principles, resulting in increased challenges in teaching and learning for SWVDs. The incorporation of UDI in the classroom does have a positive correlation with learning outcomes. Conclusion: The incorporation of UDI principles can offer a potential design for easier access to teaching and learning to enhance and maximise learning outcomes; alleviate access challenges in the classroom; and address the negative experiences thereof for SWVDs. Contribution: The study adds value to the scarce body of knowledge on UDI in the classroom for university SWVDs from a learning enhancement perspective. [ABSTRACT FROM AUTHOR]

Background: South Africa's government departments use a manual paper-based procurement system with some electronic features despite the high level of human interference contributing to corruption, favouritism and inefficiency associated with manual paper-based procurement system. This suggests a lack of readiness towards full e-procurement adoption in South Africa's public sector. However, studies on readiness factors affecting e-procurement adoption have been scantly investigated in multiple government departments in South Africa. Objectives: This study aims to determine the readiness factors that affect e-procurement in multiple government departments in South Africa. Method: A quantitative research design was adopted to sample 113 public procurement officials using a cluster sampling method from five identified national government departments across five ministerial clusters. The data were collected using an online self-administered survey questionnaire and processed and analysed through Stata Release 15 statistical analysis software. Results: Six factors were identified to influence e-procurement readiness in South African government departments. These include technology and organisation's finance, among others. These factors will aid in effective planning of government departments regarding e-procurement readiness. Conclusion: Government departments should consider the factors that influence e-procurement readiness when deciding to adopt e-procurement system. This would help government departments to plan effectively e-procurement acquisition, running and training of users and thereby streamlining their procurement processes, reducing operating costs and minimising corruption. Contribution: This study fills a lack of knowledge on the readiness factors affecting e-PP adoption in the South African government department context. The knowledge of these factors, generated through empirical analysis, would guide government departments when deciding on e-PP readiness and streamline procurement processes in South Africa. [ABSTRACT FROM AUTHOR]

Background: The increase in global plastic waste generation poses a threat to human, animal and plant life. As such, industries world-wide are encouraged to review waste management systems to prevent, minimise, recycle or recover plastic waste. There is a paucity of information on plastic waste generation by the local optical industry in South Africa, especially with respect to spectacle lens and contact lens recycling. Aim: The purpose of this review article was to provide a current outlook on spectacle lens and contact lens recycling in South Africa. Methods: Literature review of scientific papers from online databases, websites and lens material patents. Results: No studies regarding lens recycling in South Africa were found. However, data for this review were collated based on lens constituent materials. Conclusion: This review article provided an overview of lens recycling, identified the barriers and potential measures to advance plastic spectacle lens and contact lens recycling in South Africa, and suggested controlled energy recovery as an alternative pending implementation of lens recycling programmes. Contribution: This paper contributes useful information on a previously unexplored aspect of recycling in South Africa. Ophthalmic lens recycling is currently not available in South Africa, and as such, this review focuses on the current outlook, barriers and considerations for implementation of such programmes. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic diseases (PWCDs) were severely affected by the coronavirus disease 2019 (COVID-19) pandemic, as they were prevented from making the necessary visits to health facilities for medical review and to collect their medication. The emergence of the health crisis and inadequate access to quality care affected chronic care management. The perspectives of PWCDs are not known, and therefore the research on which this paper is based sought to investigate the lived experiences of these patients during the COVID-19 pandemic. Methods: A qualitative phenomenological design was used to obtain the lived experiences of PWCDs identified for participation in the study by means of purposive sampling. Patients' experiences were obtained during individual structured interviews, and a checklist was used to gather patient characteristics from their files. Results: Three themes emerged from the study findings, namely poor healthcare services, the socio-economic impact of the COVID-19 pandemic, and the psychological impact of the COVID-19 pandemic. The COVID-19 pandemic had devastating effects on PWCDs, in that they experienced barriers to accessing quality chronic care services and suffered psychological and financial difficulties that affected their health, life, needs and expectations. Conclusion: Policymakers should consider PWCDs when responding to a public health concern in the future. Contribution: The study findings may have an impact on future policies regulating the management of chronic diseases during epidemics, in order to improve patient health outcomes and satisfaction with healthcare services and the chronic care model based on the experiences of PWCDs. [ABSTRACT FROM AUTHOR]

Background: Medicinal plants (MPs) are widely accepted and used in most rural communities in sub-Saharan Africa and beyond to treat and control village chicken (VC) diseases and parasites. They are readily available, accessible and cheap. Moreover, they are nature friendly and have adapted to the local environment, making them easy to produce. Over and above, their use has health benefits for consumers. Little is known about the opportunities and challenges faced when commercialising these MPs. Aim: It imperative to unpack the opportunities and challenges that are encountered while commercialising MPs used for treating VC diseases and controlling parasites. Despite these multiple benefits, the commercialisation of these plants seems to be under researched. In South Africa, different rural communities use various MPs in their locality. For instance, most rural families in South Africa are using Aloe ferox, Helichrysum petiolare, Tagetes minuta, Lippia javanica, Agave sisalana, Gunnera perpensa and Millettia grandis. Conspicuously, not much is known about the efforts made to commercialise these products. Method: Through a systematic review of the literature, this paper unpacks the trends, opportunities and challenges faced in commercialising MPs used to treat VC disease and control parasites. Results: Results have revealed that globally MPs for VC management are not widely recognised, despite their wide usage by local communities. If properly harnessed, they have the potential to strengthen local economic development through income generation. However, currently, little is derived from the sale of these products because of the presence of middlemen. Their commercialisation efforts are hampered by the lack of organised support systems and networks, lack of regularisation strategies and clear criteria for supporting quality, protection and presumed efficiency. Conclusion: By commercialising MPs, local farmers can exploit MPs beyond the village chickens to broiler and layer chickens, thus offering alternative chicken health and affordable medicinal options for the farmers. Contribution: The study contributes to understanding the available opportunities and challenges in commercialising MPs used for village chicken health management. It further demonstrates that MPs for village health can be used to transform the livelihoods of the custodians of these plants. [ABSTRACT FROM AUTHOR]

Background: Participation in activities of daily living (ADL), education, leisure and play in children living with cerebral palsy (CP) may be affected by various factors, as outlined in the International Classification of Functioning, Disability and Health Framework (ICF). The aim of this study was to describe the participation patterns of a group of these children. Objectives: This study aimed to describe participation patterns in ADL, education, leisure and play activities of children living with CP in Modimolle. Method: An exploratory-descriptive qualitative (EDQ) study design was used. A researcher-constructed bio-demographic data sheet and a semi-structured interview schedule were used to collect data from the primary caregivers of children (5-17 years) living with CP in Modimolle. Interviews were transcribed verbatim, translated from Sepedi to English and analysed using the content analysis approach and NVivo software. Results: The findings of this study indicated that children living with CP in Modimolle require set-up and assistance to participate in various ADL such as self-care, family and community activities. They also participate in formal and informal educational programmes as well as active and passive leisure and play activities. However, at the moment, they have limited opportunities to participate because of resource constraints and inaccessible infrastructure. Conclusion: Although children with CP in Modimolle perform some ADL, and participate in educational, leisure and play activities, they are not fully integrated into their community. Legislative support and policy implementation are required to improve participation and integration of children living with CP. Further studies on community-specific integrative strategies to enhance participation among children living with disabilities are recommended. Contribution: This paper provides valuable information on the participation patterns of children with CP living in a rural area of South Africa. The findings can assist with development and implementation of community-specific, integrative health and social care strategies to enhance participation among children living with disabilities. [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]

Background: Epilepsy is responsible for a significant proportion of the world's disease burden, affecting around 50 million people globally. A seizure diary is a self-management tool for epilepsy focusing on self-monitoring, tracking seizures and other symptoms. This study aimed to determine the perceptions and attitudes to the seizure diary in patients with epilepsy in the Free State and Northern Cape of South Africa. Methods: This cross-sectional survey method included adult patients with epilepsy attending Universitas Academic Hospital Specialist Epilepsy Clinic in Bloemfontein and local clinics in Kimberley (City, Beaconsfield and Betty Gatsewe), as well as the casualty department of Kimberley hospital (Robert Mangaliso Sobukwe Hospital). The Kimberley patients were diary-unexposed, while the Bloemfontein patients were patients who had previous exposure to the seizure diary. Results: A total of 182 patients with epilepsy were recruited for the study, of whom 65 were patients who had previous exposure to the seizure diary, and 117 were unexposed. In the patients who had previous exposure to the seizure diary, 64 (98.5%) found the diary useful, but 15 (23.1%) reported having various challenges with using the seizure diary. Almost all of the patients who had previous exposure to the seizure diary, 64 (98.5%), were willing to continue to use the diary, while 112 (95.7%) of the diary-unexposed patients were also willing to use the diary. Conclusion: Information from some patients using the diary confirms various challenges with its use; however, most patients support the continued usage of the diary. [ABSTRACT FROM AUTHOR]

Background: The various organisations that are involved in property transfer transactions tend to work as autonomous units within the end-to-end property supply chain. This compartmentalisation of activities and tasks creates inefficiencies and a lack of transparency. Objectives: There is a need to review the current paper-based processes by evaluating the end-to-end processes in their entirety. Method: Semi-structured qualitative interviews were conducted with prominent role-players involved in the property transfer process in South Africa. The general systems view was used as the theoretical underpinning of the research, whereby property processes across the property supply chain should be viewed as a single system. Results: Enterprise resource planning (ERP) systems may assist in integrating workflow processes to enhance productivity and collaboration, and improve overall property processes. The participants confirmed the need for a centralised platform with integrated workflows. Conclusion: Participants who were interviewed concurred that a centralised system would produce numerous benefits and enhanced efficiencies through a streamlined and more transparent process. Therefore, the researcher recommends that an ERP system be introduced across the property supply chain. A centralised ERP management system would enable all parties to a particular property transaction to have sight of the progress of the transaction and reduce capturing errors across various systems. Contribution: The article will be useful within the immovable property industry, as well as to the buyers, sellers, and academia. Future studies could focus on how an ERP system could be integrated into the property supply chain. [ABSTRACT FROM AUTHOR]

The church has a key role to play in addressing the chronic levels of grief and trauma experienced by the youth in South Africa. It has a biblical mandate to bring hope and healing and has a unique station within South African society that positions it to bring about real transformation. 'Sinawe' (Zulu for [we are with you]) is a programme developed by Scripture Union South Africa to equip local churches as change agents through a relational youth ministry model that engages trauma, grief and holistic needs, both physically and spiritually. This is an important first step for churches wanting to reach and minister to young people. The South African church has an important and legitimate role to play in the lives of young people. Research indicates that although the church is considered by local residents as an important community resource, it remains ineffectual in intentional community-based youth ministry that leverages significant opportunity. This research identifies the church as an important community change agent and encourages church leaders to step into the open gap to reach local young people while providing the methodology with which to do so. This research paper examines the current South African social context, outlines a theological mandate for church involvement and presents a methodology for a supportive and effective approach to community engagement in the lives of young people led by local churches. Interdisciplinary: The article is relevant to the following disciplines within theology; missiology, family and youth ministry and pastoral care. It also has interfaces with education and sociology. [ABSTRACT FROM AUTHOR]

Background: The increase in global waste generation has adverse impacts on the environment. Significant volumes of waste are generated in the lifecycle of spectacles, contact lenses (CLs) and associated products, and there is a lack of published data on their disposal practices. Aim: To determine optometrists' recommendations to their patients, and lens wearers' practices regarding the disposal of ophthalmic lenses and associated lens products. Setting: Optometrists and lens wearers in South Africa. Methods: Surveys were distributed via online platforms to optometrists and lens wearers and paper copies of the surveys were also available. Data from both surveys were analysed using IBM SPSS version 24. Results: Responses from 353 optometrists and 603 lens wearers were analysed. Optometrists were highly likely to recommend that patients should discard their old spectacle lenses (24%), and used CLs into wastewater systems (10%), or make no recommendations on either, respectively, (16%, 12%). Lens wearers were highly likely to retain their old spectacles upon new purchase (57%) and dispose used CLs into wastewater systems (37%). Less than 20% of optometrists and lens wearers were highly likely to recommend and engage in recycling of associated ophthalmic products. Conclusion: The disposal of CLs into wastewater systems, which contributes to microplastic pollution, must be highlighted and avoided. Optometrists should incorporate disposal instructions with all products sold to patients and promote recycling. Lens wearers should also be mindful of the environmental impact of their disposal practices. Contribution: This study provides previously unknown data on ophthalmic lens disposal practices in South Africa, and emphasises the need for environmental awareness. [ABSTRACT FROM AUTHOR]

Background: The components of information systems (ISCs) have become a critical factor in the adoption of enterprise application architecture (EAA) for supply chain management (SCM) within small and medium enterprises (SMEs) when used reciprocally with competent capital formation, mainframe and personal computers, application software systems, and information technology expert. The current study examined information systems components (ISCs) as they were used in the adoption of EAA in SMEs, scrutinised the Theory of Planned Behavior, and systematic literature review. Objective: This paper seeks to contribute to the fundamental aspects of ISCs that influence the adoption of EAA for SCM in small and medium enterprises (SMSs) in South Africa, located in Limpopo Province of Capricorn District Municipality. Methodology: A quantitative survey presented both diagnostic tests and data analysis as that of the methodological modus operandi. Descriptive data analysis generated Pearson's correlation and coefficient, along with analysis of variance (ANOVA) and linear regression. Data was collected through stratified random sampling of SME owners and managers. Results: The most substantial results indicate that ISCs should be integrated with transactional support systems (TSSs), management information systems (MISs), information systems governance (ISG), decision support systems (DSSs), executive support systems (ESSs), knowledge management systems (KMSs), and web application architecture (WAA) to predict EAA acceptance. Conclusion: This article described the greatest possible direction for considering ISCs when planning to integrate EAA adoption. Furthermore, the research results provide a preliminary overview and analysis of the results that support the alternative hypothesis that ISCs influence SCM adoption and implementation of EAA in SMEs. [ABSTRACT FROM AUTHOR]

Background: The family planning service requires a routine health information system (RHIS) that can produce quality data that will be used for making decisions. However, the quality of data generated is not always of a good standard. Its usefulness in making data-driven decisions in family planning service is questionable. Aim: The study intended to assess the quality of family planning data and determine healthcare providers' (HCPs') views on factors influencing data quality in Tshwane district. Setting: The study was carried out in 13 healthcare institutions in Tshwane district, Gauteng province, South Africa. Methods: This paper reports on the quantitative strand of a mixed methods study. A sample of 111 HCPs was selected through a stratified random sampling technique, and six months of monthly reports from 13 institutions were reviewed for data quality. A self-administered questionnaire and a tick sheet were utilised to collect data from the HCPs and to review monthly reports for data quality, respectively. The Statistical Package for the Social Sciences (SPSS) programme for Windows version 24.0.0 was used to analyse the data. Results: Data quality, mainly accuracy and timeliness, was a challenge. Many HCPs were not trained in the RHIS. They viewed several issues relating to organisational, behavioural and technical factors as barriers to data quality. Conclusion: The low quality of family planning data has a negative impact on policy development and decision-making. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) has highlighted the scope of heroin dependence and need for evidence-based treatment amongst marginalised people in South Africa. Acute opioid withdrawal management without maintenance therapy carries risks of increased morbidity and mortality. Due to the high costs of methadone, Tshwane's Community Oriented Substance Use Programme (COSUP) used tramadol for opioid withdrawal management during the initial COVID-19 response. Aim: To describe demographics, route of heroin administration and medication-related experiences amongst people accessing tramadol for treatment of opioid withdrawal. Setting: Three community-based COSUP sites in Mamelodi (Tshwane, South Africa). Methods: A retrospective cross-sectional study was conducted. Data were collected using an interviewer-administered paper-based tool between April and August 2020. Descriptive statistics were used to analyse data. Results: Of the 220 service users initiated onto tramadol, almost half (n = 104, 47%) were not contactable. Fifty-eight (26%) people participated, amongst whom most were male (n = 55, 95%). Participants' median age was 32 years. Most participants injected heroin (n = 36, 62.1%). Most participants experienced at least one side effect (n = 47, 81%) with 37 (64%) experiencing two or more side effects from tramadol. Insomnia occurred most frequently (n = 26, 45%). One person without a history of seizures experienced a seizure. Opioid withdrawal symptoms were experienced by 54 participants (93%) whilst taking tramadol. Over half (n = 38, 66%) reported using less heroin whilst on tramadol. Conclusion: Tramadol reduced heroin use but was associated with withdrawal symptoms and unfavourable side effects. Findings point to the limitations of tramadol as opioid withdrawal management to retain people in care and the importance of access to first-line opioid agonists. [ABSTRACT FROM AUTHOR]

In 2015 the Western Cape Government (WCG) in South Africa introduced the e-Learning Game Changer initiative to offer teachers in public schools information and communications technology (ICT) resources to improve their pedagogy. Despite the efforts by the WCG to improve ICT use for teaching in public schools, successful ICT integration hardly takes place in several historically disadvantaged (albeit affluent) schools, which constitute a minority of schools in the Western Cape. The primary aim of this study was to investigate those conversion factors allowing or impeding teachers in two public primary schools in the Western Cape from attaining the potential capabilities required for successful ICT integration. Amartya Sen's capability approach was used as the study's theoretical framework. The study employed a qualitative research method involving 10 educators observed during their lessons and interviewed. The findings confirmed that only a few conversion factors, such as the attainment of ICT skills through a community of practice and university training by the teachers, provided them with capabilities to use ICT to deliver curriculum content and perform basic ICT skills effectively. Several conversion factors, including teachers' age, provincial and school policies, infrastructure and resources, prevented these teachers from realising their ICT potential. This study contends that the White Paper on e-Education (2004) policy might benefit from the results, which could help to build or rethink programmes that encourage continual teacher training. Transdisciplinarity Contribution: This research shows that policymakers need to take into consideration the conversion factors that may impact teachers' capabilities to deliver curriculum utilising ICTs. This study's findings provide new light on how these conversion factors limit or expand teachers' ICT capabilities. [ABSTRACT FROM AUTHOR]

The effectiveness of a government's communication, especially in times of crisis, is crucial to its legitimacy, reputation, disaster management and its ability to ensure the wellbeing of its people. This paper examines the focus and trends in press statements published on South Africa's official coronavirus website during the coronavirus disease 2019 (COVID-19) pandemic. Government decisions, successes and challenges were frequently communicated to the public through these statements. The study aimed to understand what was communicated regarding government's priorities and the factors that shaped them. Data were extracted from 483 press statements published between 05 March 2020 and 15 January 2021. Thematic analysis and mean scores were used to identify the focus and trends in the messages, while the Wilcoxon signed rank test (WSRT) was used to identify the significance of the changes in the mean scores. The results showed a coordinated and persistent effort to inform the public with credible, accurate, timely and empowering information. The most persistent priority of the government was to control the spread of the virus, while several issues relating to the socioeconomic wellbeing of the people were prioritised at different stages of the pandemic. There was a parallel movement between the trajectory of the disease and government decisions, suggesting that government response was mostly reactive to the behaviour of the pandemic. The South African government needs to be more proactive in its disaster response and demonstrate a nuanced understanding of its citizens and their challenges. [ABSTRACT FROM AUTHOR]

The Hooper Visual Organization Test (HVOT) was designed to measure an individual's ability to organise visual stimuli and assess visual-spatial abilities and synthesis. The current investigation sought to explore the psychometric properties of the HVOT and develop normative data for South Africans who do not speak English as a first language and who received primary and secondary public education. The research design was cross-sectional and the HVOT was administered to healthy adults (n = 111) and a clinical group (n = 17) whose ages ranged between 19 and 70 years and had an education of between 6 and 22 years. The clinical group was made up of Huntington's Disease patients (HD/HDL2). Reliability indicators (McDonald's omega and Rasch person reliability index) were satisfactory. The HVOT fit the Rasch model well, although item locations deviated somewhat from the expected monotonic increase in item difficulties. Statistically significant differences in total scores were observed across age, education and gender groups, forming the basis of the norms presented in this paper. A few items across these groups were flagged for potential differential item functioning. Several statistically significant associations with the Montreal Cognitive Assessment (MOCA) were observed. These were consistent with theoretical expectations and provided evidence of convergent validity. The clinical group performed worse than the control group when mean total HVOT scores were compared. Preliminary norms stratified by age, gender and years of education are presented. Future studies should include larger sample sizes and additional research on the influence of gender on the total HVOT score is needed. [ABSTRACT FROM AUTHOR]

This is the second part of an investigation of the subject of injustice relating to the issue of human sexuality in a mainstream South African Christian denomination. The first paper, entitled 'Hated without a reason I -- Contending with issues of human sexuality in a South African ecclesial context: A case study of the Uniting Presbyterian Church in Southern Africa', sought to trace the development of the issue from 1999 to 2016. This article considers the issue from the standpoint of an individual. Within the Uniting Presbyterian Church in Southern Africa (UPCSA), views have polarised along lines determined by views on the authority of scripture and biblical hermeneutics, with little hope for a resolution that will satisfy all the parties concerned despite proposals being made because of a 'failure of love'. [ABSTRACT FROM AUTHOR]