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A paper that compares emigration to the process of uprooting. Topics discussed include systemic interconnectedness, the impact of emigration on the family life and social networks of South African emigrants, and social and interpersonal of impact of departure. Information on how to maintain relationship with extended family and friend following migration is offered.

The use of religion and spirituality in psychotherapy has been a contentious issue for decades. This paper explores and describes whether psychologists would use religion and spirituality in psychotherapy as well as enablers and barriers in this regard. A qualitative exploratory descriptive method was followed using purposive sampling to obtain a sample of clinical and counselling psychologists. The focus group strategy was used to collect the data, and Tesch's model of content analysis was used to analyse the qualitative findings. Most participants expressed a willingness to discuss religion and spirituality with their clients. Participants also highlighted specific enablers and barriers to incorporating religion and spirituality in psychotherapy. This article has the potential to influence professional training in psychology and psychotherapy. [ABSTRACT FROM AUTHOR]

Current guidelines on HIV prevention for MSM emphasise the need for 'combination prevention' based on context-specific understandings of HIV risk. MSM in South Africa are a population with a high risk of HIV infection, however there is little research available on the drivers of this risk. In the context of a focus on combination prevention, this paper argues that effective HIV prevention for MSM in South Africa requires an understanding of the factors at multiple 'distances' from individuals that contribute to HIV risk. Based on qualitative research with MSM in Cape Town, South Africa, we situate HIV risk using a socio-ecological framework and identify factors at distal, proximal, and personal, levels that contribute to MSM's high risk of HIV infection. By understanding the interactions and linkages between risk environments and the risk situations in which HIV is transmitted, HIV prevention programmes will be more effectively able to address the multiple drivers of HIV risk in this population. [ABSTRACT FROM AUTHOR]

Public nuisance caused by livestock has resulted in many local governments having a designated area to keep them, called commonages. In Makhanda, livestock owners often do not effectively utilize commonages; they let animals wander in the streets and keep them in the backyards, which is against municipal regulations. This study uses Lefebvre's production of the space-spatial triad, which provides a holistic understanding of why bylaws are circumvented in Fingo Village. The focus is on the dialectic process in the spatial triad between representational space and representations of space to understand spatial patterns. Purposive sampling methods were used to select ten household plots in Fingo Village. Primary data was collected using semi-structured interviews. The study's findings reveal that bylaws are circumvented because there are spatial contradictions between the conceived land use designations of the Makana Municipality and the lived experiences of the users/inhabitants. Three issues were noted: conceived ideas were not inline with cultural beliefs about livestock keeping in backyard kraal; commonage geographic location was not ideal as it's not visible to residential areas so users can see them while grazing, which increased chances of livestock theft; and Makana Municipality not effectively enforcing regulations and administering commonages. [ABSTRACT FROM AUTHOR]

Objective: The objective of this article was to analyse women's perceptions of ICMC and to propose a framework for ICMC decision-making that can inform ICMC policies. Method: Using qualitative interviews, this study investigated twenty-five Black women's perceptions of ICMC decisionmaking in South Africa. Black women who had opted not to circumcise their sons, were selected through purposive and snowball sampling. Underpinned by the Social Norms Theory, their responses were analysed through in-depth interviews and a framework analysis. We conducted the study in the townships of Diepsloot and Diepkloof, Gauteng, South Africa. Results: Three major themes emerged: medical mistrust, inaccurate knowledge leading to myths and misconceptions, and cultural practices related to traditional male circumcision. Building Black women's trust in the public health system is important for ICMC decision-making. Conclusions for Practice: Policies should address misinformation through platforms that Black women share. There should be an acknowledgement of the role that cultural differences play in the decision-making process. This study developed an ICMC perception framework to inform policy. Significance: What is already known on this subject? Male circumcision decision-making is complex because multiple, interrelated factors influence it. Deciding about circumcising infants and children is a challenge that many parents face. What this study adds? This study found that social pressure from the social network, myths and misconceptions resulting from inaccurate knowledge, medical mistrust and traditional male circumcision practices influence the decisions of Black women not to circumcise their sons. The study proposes a perceptions framework to demonstrate consideration for Black women's voices in the male circumcision discourse. [ABSTRACT FROM AUTHOR]

In this case study I explored the dilemmas of three early childhood care and education (ECCE) teachers in a poor community in the Cape Flats of Cape Town, South Africa during COVID-19, and how they used these dilemmas to transform their teaching. Purposive sampling was used to select the participants and data was collected through a semi-structured interview and thematically analyzed. Ethical clearance was secured from the Cape Peninsula University of Technology. Mezirow's transformative learning theory was used as an analytical framework for the study. In particular, Mezirow's concept of disorienting dilemmas was used to engage with the dilemmas the ECCE teachers were confronted with during the pandemic. Further, his concept of perspective transformations was used to analyze how the ECCE teachers engaged with these dilemmas to transform their teaching. Findings show that while ECCE teachers' faced disorienting dilemmas of digital inequity and of children's interactive play, they also adopted alternative roles and actions as they engaged in dialogue and shared negotiations, ensuring that the functioning of the ECCE centre would continue in solidarity with the children and parents. These findings have important implications for how local government provide financial and digital support for poor communities during times of crisis. [ABSTRACT FROM AUTHOR]

Severe mental illnesses (SMI) contribute significantly to the global burden of disease. In low-and-middle-income countries (LMICs), the treatment gap impacts the clinical and personal recovery of people living with an SMI. The drive to reduce this treatment gap in LMICs makes it pertinent to understand service providers' views on recovery from SMI. Semi-structured interviews and focus groups with service providers from health services and non-profit organisations in the Western Cape Province, South Africa, were conducted in this qualitative study. Seventeen participants were purposively selected, and data were thematically analysed. Three major themes emerged: delineating recovery, available services supporting recovery from SMI, and facilitators and barriers to recovery at the service level. Health services favoured clinical over personal recovery. Participants thought that many service users' personal recovery from SMI was hindered by intersecting social, economic, cultural, and political inequalities that extended beyond the influence of the health sector. [ABSTRACT FROM AUTHOR]

Despite a decade of advancing HIV/AIDS treatment policy in South Africa, 20% of people living with HIV (PLHIV) eligible for antiretroviral treatment (ART) remain untreated. To inform universal test and treat (UTT) implementation in South Africa, this analysis describes the rate, timeliness and determinants of ART initiation among newly diagnosed PLHIV. This analysis used routine data from 35 purposively selected primary clinics in three high HIV-burden districts of South Africa from June 1, 2014 to March 31, 2015. Kaplan-Meier survival curves estimated the rate of ART initiation. We identified predictors of ART initiation rate and timely initiation (within 14 days of eligibility determination) using Cox proportional hazards and multivariable logistic regression models in Stata 14.1. Based on national guidelines, 6826 patients were eligible for ART initiation. Under half of men and non-pregnant women were initiated on ART within 14 days (men: 39.7.0%, 95% CI 37.7-41.9; women: 39.9%, 95% CI 38.1-41.7). Pregnant women initiated at a faster rate (within 14 days: 87.6%, 86.1-89.0). ART initiation and timeliness varied significantly by district, facility location, and age, with little to no variation by World Health Organization stage, or CD4 count. Men and non-pregnant women newly diagnosed with HIV who are eligible for ART in South Africa show suboptimal timeliness of ART initiation. If treatment initiation performance is not improved, UTT implementation will be challenging among men and non-pregnant women. UTT programming should be tailored to district and location categories to address contextual differences influencing treatment initiation. [ABSTRACT FROM AUTHOR]

Spirituality is recognized as an essential and integral component of a holistic approach in occupational therapy practice. However, little is known about occupational therapy students' perceptions regarding spirituality in learning context. This study used qualitative exploratory, descriptive design to explore the occupational therapy students' perceptions about spirituality in training. Using purposive sampling, four semi-structured interviews were conducted with two students, a lecturer and an occupational therapist. In addition, two focus groups were conducted with students in order to collect data. Data collected were audio-taped; transcribed and thematic analysis was used to identify themes. The analysis resulted in emergence of four themes: 'Unique to every individual,' 'Spirituality in occupational therapy,' 'To be or not to be taught,' and 'The Real world.' Participants perceived spirituality as an individually experienced. The study contributes to the body of knowledge base of occupational therapy education regarding spirituality. However, there is a need for guidelines to integrate spirituality in occupational therapy training. [ABSTRACT FROM AUTHOR]

HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who presented for voluntary counseling and testing in Soweto to elicit a broad range of detailed perspectives on ART refusal. We then integrated our core findings into an explanatory framework. Participants described feeling 'too healthy' to start treatment, despite often having a diagnosis of AIDS. This subjective view of wellness was framed within the context of treatment being reserved for the sick. Taking ART could also lead to unintended disclosure and social isolation. These data provide a novel explanatory model of treatment refusal, recognizing perceived risks and social costs incurred when disclosing one's status through treatment initiation. Our findings suggest that improving engagement in care for people living with HIV in South Africa will require optimizing social integration and connectivity for those who test positive. [ABSTRACT FROM AUTHOR]

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Although recognized as a vulnerable population, there is no national population size estimate for sex workers in South Africa. A rapid sex worker enumeration exercise was undertaken in twelve locations across the country based on principles of participatory mapping and Wisdom of the Crowd. Sites with a range of characteristics were selected, focusing on level of urbanisation, trucking, mining and borders. At each site, sex worker focus groups mapped local hotspots. Interviews with sex workers at identified hotspots were used to estimate the numbers and genders of sex workers working in each. Estimates provided in the literature were combined with enumeration exercise results to define assumptions that could be applied to a national extrapolation. A working estimate was reached of between 131,000 and 182,000 sex worker in South Africa, or between 0.76 and 1 % of the adult female population. The success of the exercise depended on integral involvement of sex worker peer educators and strong ethical considerations. [ABSTRACT FROM AUTHOR]

Religion and spirituality are recognized coping resources but are neglected in psychological training and practice. However, religion and spirituality can be successfully used to cope with psychological disorders, prevent unhealthy behaviors and promote resilience. This study explored and described two questions regarding the concepts of the terminology religion and spirituality, and the perceptions of the use of religion and spirituality in therapy. Purposive sampling was utilized in a qualitative study of 15 registered psychologists, and data were analyzed using Tesch's model of qualitative content analysis. The concepts religion and spirituality appear difficult to define but the importance of their use as coping mechanisms in their own and their clients' lives was recognized. These findings have implications for professional training. [ABSTRACT FROM AUTHOR]

Mounting evidence exists that mobile voluntary counselling and testing (VCT) is able to extend coverage to new localities and populations. We describe two feasibility and acceptability pilot studies conducted in rural and urban South Africa in preparation for the larger NIMH Project Accept HIV prevention trial. A total of 1,015 individuals participated in the pilot studies. Participants in rural Vulindlela were younger (median 22 years) compared to urban Soweto ( p < 0.001). Young people were more likely to be first time testers in both sites ( p = 0.01 in Vulindlela, p < 0.001 in Soweto), with significantly more men likely to be first time testers than women ( p = 0.01 in Vulindlela, p < 0.001 in Soweto). User satisfaction with mobile VCT was extremely high in both sites. Our study shows that providing mobile, high-quality and easy to access services in a high prevalence context is a feasible way to engage youth, men and more rural populations in HIV counselling and testing. [ABSTRACT FROM AUTHOR]

HIV bio-behavioural surveillance surveys conducted at regular intervals are critical for monitoring of, and informing a targeted response to the HIV pandemic. We used Respondent-driven Sampling in 2006, 2008 and 2010 to recruit men who have multiple female sexual partners. We performed several logistic regression analyses to compare HIV sexual risk behaviours, and HIV infection over time. Decreases in inconsistent condom use with main partners were not sustained in 2010. Inconsistent condom use with non-main partners, partner numbers and having one-time partners continued to decrease over time. Levels of alcohol consumption in 2010 reverted to a level higher than in 2006. Non-significant increases in HIV prevalence and reporting a symptom of a sexually transmitted infection (STI) were found. The decrease in numbers of and one-time sexual partners, and in inconsistent condom use with non-main partners augers well for decreasing HIV incidence among men in the study community, but might be offset by decreases in consistent condom use with main partners, and increases in alcohol consumption and STIs. [ABSTRACT FROM AUTHOR]

Interpersonal relations between health care providers and young clients have long being cited as an important element for improving client up take of services, satisfaction and overall health outcomes. In an era of HIV and AIDS this forms a critical determinant to young people accessing sexual and reproductive health care. This study explores to what extent interpersonal relations form a barrier to young peoples access to and satisfaction of health services. The study draws on data from 200 client exit interviews and four in-depth interviews conducted with university students and university health care staff in Kwazulu-Natal, South Africa. While young people are aware of the importance of utilising STI, HIV and family planning services they experienced barriers in their relationship with providers. This served as a deterrent to their use of the health facility. Adequate training in interpersonal relations for youth-friendly service provision is essential in helping overcome communication problems and enabling providers to interact with young clients at a more personal level. [ABSTRACT FROM AUTHOR]

Research suggests that restricted access to phonological coding exacerbates deaf children's reading and writing problems. Conversely, bilingual-bicultural programs are advocated on the hypothesis that well-developed sign language skills and visual coding strategies (based on sign language) may offer deaf children phonological/orthographic link, thus enhancing their written English skills. To test this hypothesis, this study used a quasi-experimental pre- and post-test design among prelingually profoundly deaf (late-signing) elementary-phase children attending a residential school for the Deaf in rural South Africa (treatment group: N = 32, mean age = 119.19 months, SD = 22.73, comparison group: N = 32, mean age = 117 months, SD = 21.36). After a year of computer-based exercises explicitly guiding them in fingerspell coding, visual imaging and the principles of 'print-language mapping' between South African Sign Language and English, the pre- and post-test results revealed that the treatment group had made significant gains in spelling proficiency. [ABSTRACT FROM AUTHOR]