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The South African government's response to the universal crisis of global warming has resulted in the creation of the National Climate Change Response White Paper, a proposed country-wide course of action that would aid in the stabilization of greenhouse gas emissions and intervene in current harmful environmental practices. The role of communication and the media is crucial to the success of any policy implementation as well as of the establishment of an 'action-inspired' mind-set amongst citizens that will bolster lifestyle change to support the cause. This paper will assess the National Climate Change Response White Paper in conjunction with climate change coverage from the South African daily online news source, News 24. Additionally, films released from the Bjerkness Centre for Climate Research and discussion surrounding youth's use of relatable mediums to invoke lifestyle change from Lindie Buirski, Head of Environmental Capacity Building, Training and Education in the City of Cape Town's Environmental Resource Management (ERM) Department, will aid in analysis. Moreover, they will serve to bolster the argument of communications' critical role in realizing any goals set forth by the government. The paper will close by offering proposed climate-change directed development projects for the South African context and will refer to current international successful examples of media use to carry the message of climate change, while inviting audience input, participation, and most importantly, action. [ABSTRACT FROM AUTHOR]

Purpose: There is a growing call both globally and nationally for integrated multisectoral and multidisciplinary systems of care to be implemented for children's needs in the foundation stages of their growth to be met. Extant literature shows that historical, structural, epidemiological, political and social factors create many adversities for South African children both in the short and in the long term. South Africa's fragmented and weak service delivery compounds the situation. In this paper, the authors describe the lessons learnt from a multisectoral and multidisciplinary community of practice established to strengthen social systems to ensure child wellbeing outcomes. Design/methodology/approach: A qualitative research design was used, drawing on data collected over a two-year period. Data included meeting minutes, focus group discussions, and email communications between project partners. Focus group discussions were audio-recorded and transcribed verbatim. Data was analysed thematically. Findings: Findings show that having a shared goal, establishing supportive, mutually beneficial relationships and contributing to services that enhance child wellbeing outcomes enabled the community of practice, while differing organizational mandates and heavy workloads constrained the partnership. Research limitations/implications: The study shows the effectiveness of a Community of Practice (CoP) in integrating services across sectors for children's well-being and promoting collaborative learning and intersectoral work. However, this success also depends on the presence of strong leadership and efficient coordination.Limitation: Despite its benefits, the CoP model presents challenges, including securing active participation and buy-in from stakeholders, managing time and resource constraints, and dealing with issues in the existing service delivery system. Questions about long-term sustainability and the practicalities of scaling and institutionalizing the model need to be addressed. Originality/value: Through this paper, the authors contribute to a nascent area of research in the Global South, critically reflecting on the lessons the authors learnt from implementing an integrated community of practice approach to strengthen social sector systems toward the enhancement of children's wellbeing. [ABSTRACT FROM AUTHOR]

Genetic counseling (GC) traditionally follows a non-directive counseling approach. Although a cornerstone of GC teaching and theory, there has been debate on whether GC is, can be, or should be a patient-led service due to challenges in practice, as well as the advancement and complexity of genetic testing. Personal risk perceptions and patient expectations within particular contexts may further affect how genetic counselors discuss risk information, even while attempting to remain neutral. Less is known about the process of GC communication in non-Western settings. This paper presents empirical evidence from a South African prenatal GC consultation where tensions become apparent due to differing risk perceptions and expectations between a genetic counselor and a patient, which ultimately impacts non-directive communication practice. The case study forms part of a larger qualitative study focusing on risk and uncertainty communication within GC consultations in Cape Town, South Africa. A blended sociolinguistic approach drawing on principles of conversation analysis (CA) and theme-orientated discourse analysis (TODA) provides evidence of the complexity of imparting risk information and challenging patients to reflect on their decision-making, whilst refraining from sharing personal risk perceptions during everyday practice. The case study demonstrates how a genetic counselor may become implicitly and explicitly directive in their communication approach within the same consult which may reveal their personal risk perceptions on the matter discussed. In addition, the case study reveals how a genetic counselor may grapple with the dilemma of honoring the non-directive guidelines of the profession, whilst simultaneously supporting a patient who requests advice. The ongoing debate on non-directive counseling, decision-making, and patient care in GC is important for the reflection and development of the profession to understand how to assist and support patients facing sensitive and difficult decisions, in a meaningful, and contextually-tailored manner., (© 2023 National Society of Genetic Counselors.)

Aims: To identify the influence of teamwork, communication skills, and structural empowerment on providing patient‐centered care among nurses in Eswatini. Design: A quantitative, cross‐sectional survey was used. Methods: This survey conducted in Eswatini selected registered nurses working as full‐time nurses with more than 3 months of working experience using convenience sampling. Different measures were adopted and used to collect data among 130 eligible nurses from February to March 2022. Data were analyzed using Statistical Program for Social Sciences version 26.0. Results: A total of 123 nurses responded in the study and the mean age was 31.05 years with a standard deviation of 5.49. The overall response rate was 94.6% in this study. Hierarchical multiple regression analysis revealed that teamwork (β = 0.236, p < 0.05) and communication skills (β = 0.328, p < 0.05) were significant predictors of the provision of patient‐centered care among nurses. Conclusion: Team‐building exercises and management interventions to empower nurses should be established to improve the provision of patient‐centered care among nurses. Nurses should be empowered to provide patient‐centered care in health facilities by encouraging them to provide their input in management procedures and planning programs. Impact: Clinical practice requires nurses to use effective communication skills and work as a team. Nursing care established on teamwork, respect, empathy, and communication skills allows patients to express their concerns and views in health facilities as they feel involved in care. Patient or public contribution: No patient or public contribution in this paper. This study only involved registered nurses as health professionals. Summary Statement: What is already known? : Patient‐centered care gives patients the chance to participate actively in discussions and consultations.Patient‐centered care requires nurses to work as a team, use effective communication skills, and feel empowered during the execution of their work.Nurses who are empowered are less likely to make medical errors, and collaborative nurses provide better patient‐centered care. What does this paper add? : Highlights that teamwork and communication skills influence nurses' ability to provide patient‐centered care.Add to the growing evidence‐based support that there is a need for teamwork and communication education programs for registered nurses in the workplace.Empowering nurses to participate in management processes and program planning will enable them to deliver patient‐centered care in healthcare facilities. Implications for practice/policy : Education programs focusing on teamwork and communication skills should be provided to nurses working in the clinical setting to enhance the quality of patient care and improve collaboration.All hospitals should adopt a tailored intervention designed to enhance the delivery of patient‐centered care to raise the standard of care.It is imperative that nurses prioritize the development of their teamwork, respect, empathy, and communication skills. [ABSTRACT FROM AUTHOR]

The burden of malnutrition experienced globally, coupled with the increasing rate of micronutrient deficiencies, compromises the health and well-being of women during their reproductive years. Obesity places young South African women at particular risk during pregnancy, and increases obesity risk for their offspring. To address these risks, the Bukhali trial is being implemented in Soweto, South Africa with 18–28-year-old women, as part of the Healthy Lifestyle Trajectory Initiative. A dietitian is part of the Bukhali intervention team (community health workers) to provide nutritional support for overweight/obese trial participants, making use of the International Federation of Gynaecology and Obstetrics (FIGO) Nutrition Checklist. This paper reflects on the experiences and lessons learned by the Bukhali dietitian, including the use of the FIGO Nutrition Checklist and Healthy Conversation Skills to facilitate conversations about making healthy dietary behaviour changes. Identified challenges that influence nutrition and behaviour are discussed, including lack of food affordability, cultural and social influences on healthy food choices, unsupportive environments and food insecurity. Strategies to optimise this nutritional support are also mentioned. The Bukhali trial is showing that introducing additional nutrition support by a dietitian for at-risk participants has the potential to encourage young women to prioritise nutrition and health, even in the midst of contextual challenges to both nutrition and health. [ABSTRACT FROM AUTHOR]

This paper presents findings from a study on blindness discourses found in South African non-profit organisations that provide rehabilitation services to visually impaired adults. The paper investigates what the public relations materials of these organisations communicate about blindness. It also considers the ideological assumptions that blindness discourses reinforce and embed in rehabilitation practice. The primary focus is a discourse analytic review conducted on a sample of organisation public facing material. The findings comprise three clusters of assumptions, with concomitant enactments in practice. These are i) third-person alliances around the blind subject and a resulting objectification of service users ii) 'journey discourse' which prohibits the expression of complex disability experiences and iii) polarised blindness fantasies which promote othering and prescribe acceptable ways of being for blind subjects. This paper questions what might be imparted to blind persons at a symbolic level through rehabilitative practices. This article explores the ways that blindness and blind persons are represented on the websites of organisations that provide visual impairment rehabilitation services in South Africa. These representations affect the way that society views visually impaired people, and the way that visually impaired people feel about themselves. Organisation websites describe visually impaired people in ways that make it seem as though they play little active role in the rehabilitation process. The idea that rehabilitation is a journey from dependence and depression to independence and self-acceptance might make it difficult for rehabilitation service users to express ongoing feelings of grief and loss. There is a need for more focus on interdependence in rehabilitation services. Rehabilitation organisations must think carefully about what their public relations materials communicate to society about blindness and blind persons. [ABSTRACT FROM AUTHOR]

Purpose: Legacies of colonialism continue to influence the profession of speech-language pathology (SLP) around the world. While there is some literature on ways in which we can decolonise the profession, there is little written on these issues in relation to research and practice in the field. In this paper, we discuss how qualitative approaches can be useful particularly in post-colonial contexts to transform research and practice in the profession. Method: Using a reflective framework, we draw on examples from several of our own research and teaching experiences that have embraced a variety of qualitative approaches, conducted across various contexts in the post-colonial South African context. Result: Qualitative approaches can play a central role in achieving transformation goals because they offer opportunities for highlighting the voices of marginalised communities and they are flexible and adaptable to the needs of particular contexts. We reflect on how qualitative approaches can be linked to SLP curricula, practice and research, and consider innovative ways in which such approaches can be embraced within the profession. Specifically focussing on research, we explore issues of access, representation and inclusion, the use of contextually relevant methods, and ethical considerations when working in post-colonial contexts. Conclusion: Many of the points raised in this article are important for all contexts. Embracing qualitative approaches offers opportunities for the SLP profession to transform and meet our mandate of providing culturally safe, appropriate, effective care. [ABSTRACT FROM AUTHOR]

The South African taxi industry has a negative image that is associated with violence and disrespect for its clients. This has led to it losing many of its clients to other industry players leading to more violence as taxi owners lose profits. The issue of communication as a possible solution to the challenges the taxi industry experiences, from the perspectives of the taxi drivers, has not been explored. Hence, this paper sought to gather the views of drivers on the role of improved communication to bringing about peace and good relations with passengers. A qualitative approach was adopted as a form of data collection in which 12 participants were interviewed in the eThekwini Metropolitan Municipality in South Africa. The participants were selected among the taxi drivers who were asked to share their communication challenges and strategies. The findings revealed that poor communication skills and language can be a barrier to communication between drivers and passengers and between taxi associations. Effective communication strategies can contribute to economic freedom and peace. A further finding from the study is that taxi drivers, acting on their own agency, can tackle communication challenges in the eThekwini taxi industry and contribute to change. [ABSTRACT FROM AUTHOR]

This paper reports a case study that explores ways to improve Saudi students' engagement with poetry in English by providing them with alternative opportunities to analyse and express themselves using technology and multimedia. It is a strategic implementation of a culturally appropriate pedagogy that utilises visual language to interpret poems in English. Independently constructing their own videos provided students with a chance to replace traditional written interpretations of poems in the classroom. Allowing L2 students to communicate and express emotions visually gives them access to their creative potential, from which they can construct more meaningful interpretations. This supports the concept of no wrong answers in the reading and analysis of poetry and allows the students to create an exploratory relationship towards reading poetry. This is important for Saudi students in particular since they are not as proficient in written English as native English students. This article also reports the students' perceptions to determine the effectiveness of visual poetry as an alternative to written analysis of poetry. I investigate the relationship between poetry and pedagogy to allow for individualised attempts to present a particular framework as a medium for studying poetry. The study showed, through their personalised videos, that Saudi students are open to using technology and multimedia that liberate them from traditional teaching techniques and allow them to unlock their interpretive skills and represent their interpretations in original ways. These findings might also have greater relevance to wider debates on extending the use of technology and multimedia as a key element for educators hoping to engage L2 students with reading and responding to poetry in English. [ABSTRACT FROM AUTHOR]

Background: HIV and sub-optimal infant feeding practices remain important threats to child growth, development, and survival in low- and middle-income countries. To our knowledge, few studies have explored health service users' perspective of infant feeding in the context of WHO Option B+ policy to prevent vertical HIV transmission (PMTCT). This paper is a sub-analysis of qualitative data from a mixed-methods multi-level process evaluation of Option B+ implementation in South Africa (SA). In this study we explored health facility users' infant feeding knowledge, perceptions, and practices one year after SA adopted the 2016 updated World Health Organization prevention of mother-to-child transmission of HIV Option B+ infant feeding guidelines. Methods: Nineteen focus group discussions (FGDs) were held with six groups of men and women whose infants were aged < 6 months. Participants were attending randomly selected primary health care facilities within six purposively selected priority districts. The six groups included in the FGDs were: (i) adolescent girls and young women living with HIV (WHIV), (ii) adolescent girls and young women not living with HIV (WNHIV), (iii) older postnatal WHIV (iv) older postnatal WNHIV (v) pregnant women, and (vi) men. Data collection took place between April and December 2018. Data analysis involved coding and thematic framework analysis. Results: Women and men have suboptimal knowledge of the recommended breastfeeding duration and exclusive breastfeeding, especially for HIV-exposed infants. Most women received sub-optimal infant feeding counselling and mixed messages from health care workers. Fewer WHIV initiated breastfeeding at birth compared to WNHIV. Most parents believed that HIV-exposed infants should be breastfed for 6 months and many postnatal women on antiretroviral drugs and younger mothers lacked confidence to breastfeed beyond 6 months. Mixed feeding was predominant among all women due to individual, family, and socio-structural barriers. Many men were supportive on infant feeding; however, they lacked the appropriate information and skills to influence their partners' infant feeding decisions. Conclusions: Differences in breastfeeding practices between WHIV and WNHIV are highly influenced by the lack of knowledge of infant feeding policy recommendations. Multiple-level factors deter many mothers from adhering to recommended guidelines. Appropriate ongoing infant feeding counselling and breastfeeding support are required for women and their partners. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to discuss stigma and insensitive communication surrounding mental illness discourse amongst adolescents in the Polokwane Local Municipality against the background of a Foucauldian lens. Design/methodology/approach: The literature reviewed included a discussion of perspectives on stigma and insensitive communication, contextualisation of the dual health–belief system in South Africa and the Foucauldian governmentality theoretical perspective. The methodology was based on a Foucauldian orientation and Geertz' interpretivism. The methods followed to analyse the discourse were Foucauldian discourse analysis (FDA), coupled with Geertz' "thick description." The data were collected from six focus group discussions, which consisted of a total of 36 informants. Findings: The findings indicated the dominance of the biomedicine discourse, neoliberal rationalisations for self-care and the policy of deinstitutionalisation. Practical implications: The implications for practice using an FDA approach combined with an interpretivist stance exposes the actions, institutions, possibilities for action whilst understanding core beliefs in a complex dual health and religious belief setting. The addition of Geertz's interpretivism adds a cultural flare and insight, which adds to the depth of the analysis. Originality/value: The complexity of beliefs, experiences and health choices calls for culturally sensitive discourse about mental illness and also highlights how discourse about individual conduct and self-care is embedded in the discourse used by adolescents. [ABSTRACT FROM AUTHOR]

This paper charts the emergence of and the movement towards new thinking on sustainable transport in the City of Cape Town, South Africa, and the adoption of a set of indicators for sustainable transport. The paper centres on two themes. It reviews the sustainable transport concepts debated and later adopted by the City of Cape Town. It then examines the day-to-day practice of developing sustainable transport indicators in Cape Town over a 14-year period, from the advent of democracy in 1994 to the present day, with a particular focus on the 2007 to 2009 period. The paper tries to shed light on the process by which ideas of sustainability get translated into indicators in the midst of many constraints including limited staff resources, uncertain politics, and changing policy priorities. [ABSTRACT FROM AUTHOR]

Indigenous peoples throughout the world, despite being known to suffer from increased risk of stroke and traumatic brain injury (TBI), are marginalised in terms of access to rehabilitation services and have poorer health outcomes than non-indigenous peoples. Speech-language pathology services for indigenous people with aphasia have rarely been discussed in either clinical or research fora in this field, with few guidelines available for clinicians when working with indigenous clients, families, and communities. Exploiting the broad input gathered through the collective problem-solving of a focus group, the paper integrates the input of a group of practitioners and researchers at an international roundtable held in 2016 to generate a "declaration" of issues that need to be addressed regarding aphasia services for indigenous clients with aphasia. The paper aims to promote a transformative approach to service delivery that is driven by decolonizing attitudes and practices, and acknowledges historical, sociopolitical, linguistic, and family contexts as a framework for understanding indigenous clients with aphasia. [ABSTRACT FROM AUTHOR]

This paper evaluates a South African rural telecentre that may serve as a ‘best practice’ model. The paper first provides a brief literature review of telecentres and the role of information and communication technology in economic development. A qualitative evaluation of a case study is presented within the context of sustainability considerations and development outcomes; that is, showing how the telecentre has improved the lives of the rural community at Thabina. Some of the observed economic development impacts are listed in the paper and an attempt is made to capture the essence of the vital links between the use of information and communication technology (technology transfer), human development, education and economic development. [ABSTRACT FROM PUBLISHER]

Background: Strengthening pre-adolescents knowledge and skills through an age- and culturally-appropriate intervention could prevent health issues later in life. Early interventions could influence the trajectory of future risky behaviour, and may influence health behaviour amongst their parents. The CIrCLE of Life Initiative was developed to address HIV and obesity. We evaluated whether the combined intervention increased knowledge, enhanced skills, and/or promoted healthy behaviour among students (9-12 years old) and their parents.Methods: The study was conducted from May to December 2018. Trained educators delivered 30-min lessons over ten consecutive weeks with 537 Grade 6 students at five government-run schools, in a district, in South Africa. Schools were purposively selected based on socioeconomic status and urban-rural classification. Students communicated with parents through shared homework activities. A pretest-posttest study design was used, with a 3-month follow up. Both groups completed self-administered paper-based questionnaires. A score of subscales was used in analysis. The pretest and posttest scores were compared for students and parents using a dependent t-test. Differences in outcomes by school quintile were compared using one-way ANOVA.Results: Response rates were high for both students (80.6%) and their parents (83.4%). Statistically significant differences were observed in HIV knowledge in students pretest (mean 8.04, SD 3.10) and posttest scores (mean 10.1, SD 2.70; p < 0.01), and their parents (mean 10.32, SD 2.80 vs 11.0, SD 2.50; p < 0.01). For both students and parents, pre- and post-test obesity awareness mean scores were similar, 1.93, SD 0.92 and 2.78, SD 0.57; p < 0.01, for students; and 2.47, SD 0.82 and 2.81, SD 0.54; p < 0.01, for parents. In the posttest, statistically significant changes were also observed in both groups, enhancing skills in measuring body mass index and pulse rate, and interpreting food labels. Students had a high intention to share gained knowledge with parents who had a high intention to receive it (89.4 and 89.5%, respectively).Conclusion: The intervention increased knowledge about HIV and obesity-related awareness, and it enhanced skills in selected outcomes among pre-adolescents and parents. Accurate messages and enhanced communication skills could support inter-generational knowledge transfer.Trial Registration: ClinicalTrials.gov Identifier: NCT04307966 retrospectively registered on 12 March 2020. [ABSTRACT FROM AUTHOR]

Community engagement is crucial for controlling disease outbreak and mitigating natural and industrial disasters. The COVID-19 pandemic has reconfirmed the need to elevate community engagement to build equity, trust and sustained action in future health promotion preparedness strategies. Using the health promotion strategy of strengthening community action enhances the opportunity for better outcomes. There is, therefore, a need to improve our understanding of community engagement practices during crises, scale-up good community engagement initiatives, and improve and sustain people-centered approaches to emergency responses. This paper presents five case studies from the United States, Singapore, Sierra Leone, Kenya and South Africa that demonstrate the potential strengths that can be nurtured to build resilience in local communities to help mitigate the impact of disasters and emergencies. The case studies highlight the importance of co-developing relevant education and communication strategies, amplifying the role of community leaders, empowering community members to achieve shared goals, assessing and adapting to changing contexts, pre-planning and readiness for future emergencies and acknowledgement of historic context. [ABSTRACT FROM AUTHOR]

Concise and effective business English communication underpins successful organisations. During the 4th Industrial Revolution (4IR) much of the working day is spent in some form of communication, usually e-mails. This paper examines the effectiveness of English communication between integral parts of a business operation during the 4IR. A mixed methods approach utilising a non-experimental design was used to investigate effective business communication using e-mails in English in a medium sized organisation in South Africa. A questionnaire consisting of 10 Likert type scale questions and 5 open ended questions was used. Purposive sampling was utilised as the population was small (150 employees, final sample 55) thus results cannot be generalised. Certain barriers to communication were identified which were considered important. For instance, many staff members were second language English speakers and often misunderstand e-mails. As a result, they reported that they felt frustrated in their working life and were demotivated. It was concluded that many e-mails were challenging to staff and needed to be written in everyday English not business language. The authors recommended that workshops and initial training in business language skills when people enter the organisation should be undertaken. Human Resources could also audit the use of appropriate English.

Emotional intimate partner violence (IPV) is extremely common and has significant health and social consequences, yet typically receives much less attention in research and programming than physical and sexual IPV. This limits our understanding of how women experience and understand emotional IPV in different settings, which is required to inform effective prevention and response. This paper draws on qualitative data collected in mixed-methods impact evaluations of two IPV prevention programmes conducted as part of the What Works to Prevent Violence Against Women and Girls Global Programme. In doing so, we seek to develop a more nuanced understanding of the forms, causes and consequences of emotional IPV in heterosexual relationships in two distinct African settings. We draw on two rounds of in-depth interviews conducted with 15 women in South Africa and three rounds of interviews conducted with 57 women and men in Rwanda, all of whom were participants in the programmes, around their experiences of and conceptualizations of emotional IPV. Thematic analysis around emotional IPV was conducted and compared across both data sets, informed by a cross comparative analysis approach. The analysis found that the categories or types of acts perceived as emotional IPV by women experienced were similar across settings. Women in both contexts described public humiliation, control of mobility, access to housing and silencing as important categories of actions experienced emotional IPV. These types of emotional IPV were underpinned by similar patterns of gender inequalities, with the intention for men to assert control and power over women. The specific acts through which these categories of emotional IPV manifested in the two settings arose from contextual differences related to the social structure of relationships and dominant social norms. This analysis highlights commonalities in the underlying categorial understanding of IPV in two distinct African settings, and well as the differences in specific manifestations which stem from the social context of relationships. In doing so, we highlight both broad categorical areas of IPV that may be important to address in future research and prevention programming, as well as affirming the need for information on context-specific manifestations of emotional IPV to inform local intervention programmes., Competing Interests: The authors have declared that no competing interests exist

Background: Providing aphasia care in multilingual and multicultural settings necessitates increased attention in light of current migration and globalisation patterns. Delivering care that is meaningful and appropriate for people living with aphasia becomes challenging in cases where speech-language therapists are not able to speak the languages of people with aphasia, and in instances where there is a shortage of therapeutic resources. Traditional approaches to aphasia management thus require rethinking. The South African context embodies some of these challenges, with a lack of sufficient speech-language therapists and many unable to speak the languages of the majority population. Aims: Drawing from a framework of Ethics of Care and extending it to include the notion of community, this paper proposes a model of what a "community of care" might look like for people living with aphasia in diverse contexts. Several examples from a synthesis of qualitative studies conducted in the diverse South African context are used to illustrate and expand on a model of community of care. This work has explored communication opportunities and social activities across a range of community and residential care settings, incorporating the perspectives of people with aphasia, speech-language therapists and community members involved in caring for people with aphasia. Main contribution: A "community of care" perspective involves a broader conceptualisation of the care team and its contributors, including people such as employed caregivers who can potentially play an important role in the rehabilitation process. Similarly, a broader view of context is required, in particular its role in facilitating or inhibiting communication opportunities through focusing on aspects such as community activities, place of abode, and contextual nuances. "Care" needs to be considered as extending beyond the therapy room or rehabilitation centre, and group therapy may play a particular role in contributing to a sense of community for people with aphasia and meeting cultural needs. Tools such as narrative and ethnographic approaches may facilitate a stronger focus on the lifeworld of the person with aphasia and thus also strengthen a community of care perspective. Conclusions: A community of care perspective builds on existing approaches to aphasia management that consider the broader context and community. The potential role of the speech-language therapist in enabling a community of care for people with aphasia in multicultural settings is considered. [ABSTRACT FROM AUTHOR]

Local climate governance has become a key focus of the climate change agenda. Much research has been conducted on the topic in northern countries, but more research is needed in the South, where local governments often are less equipped to deal with challenges associated with climate change. This paper discusses different forms of local climate governance, with a specific focus on the relevance of networks. Local climate governance in eThekwini Municipality, South Africa, is used as a case study, particularly focusing on a campaign that was implemented in 2011 before the international climate conference (COP17). The modes of governing in eThekwini are considered through a framework of local climate governing and identified mainly as self-governing and governing through enabling, the campaign being an example of the latter. The campaign also exemplifies how network governance can shape climate policy and significantly alter a project from initiation to implementation. While networks can contribute to improved communication and information exchange, there may be an inherent risk of private partners having a perverse incentive against implementing effective climate policies due to their own interests in maintaining current structures. It is not clear whether the change from regulative governance to governing by enabling will lead to more effective climate policies in the longer term. More research is required to determine this. While this study is too small to make broader generalizations, it does provide insight into how the introduction of network governance may impact climate governance at the local level in the South. Copyright © 2017 John Wiley & Sons, Ltd and ERP Environment [ABSTRACT FROM AUTHOR]

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

In this article, I examine the case study of a secret communication infrastructure developed as part of Operation Vula and operational from 1988 to 1991 during the final years of the South African liberation struggle. The purpose of Vula was to bring key leaders back from exile to steer from the ground the machinery of mass movement against the apartheid regime. To make Vula a reality in a highly militarised South Africa in the late 1980s a whole infrastructure of covered resistance (physical, technical, and people-based) was necessary. I propose the concept of fugitive infrastructure to understand this form of resistance. I suggest that the secret Vula mission and its communication system can be interpreted as a fugitive infrastructure whereby the system comprised not only an instrument for coordinating resistance to the apartheid regime but also a materialisation, at the level of infrastructure, of a potential alternative future for South Africans. Methodologically, this paper is based on mixed data collection methods including empirical and archival materials collected and analysed during my Ph.D. research. [ABSTRACT FROM AUTHOR]

Employees in public hospitals in South Africa work under dreadful conditions and are at risk of developing psychological stress and occupational diseases as well as occupational injuries. These poor working conditions translate to poor service delivery and as a result, the patients are the ones who suffer the most while under the care of these healthcare professionals. Despite these poor working conditions in public hospitals, there are limited studies that have dealt with this important topic in South Africa. The purpose of this paper was to describe a conceptual model which can be used as a framework of reference to improve the working conditions and the health and safety of employees at selected public hospitals in South Africa. A descriptive, explorative and theory construction research design was used to construct a conceptual model for improving the working conditions in public hospitals in the specific province in South Africa. The model suggests that improvement of working conditions, employee health and safety and quality patient care can only be achieved if employees and managers work interdependently for the betterment of the working conditions of their hospitals. Improvement should focus on enablers such as leadership commitment, infrastructure, resources, safety and security communications, decision-making, interpersonal relationships, support, and education and training. The implication for the managers and employees is that the model can be used as a framework for improving working conditions in hospitals, to promote the health and safety of employees and to improve quality patient care. [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]

This paper focuses on the role of codeswitching (CS) by isiZulu (Zulu) native language (NL) junior secondary learners in English first language (EL1) multilingual classrooms in South Africa. In spite of the educational transformation in South Africa, and the recognition of CS (by education policy documents) as a means of fulfilling pedagogical objectives, the use of CS in the classroom, more particularly in the EL1 classroom, is mostly prohibited. Nevertheless, the research, from which this paper is drawn, reveals that learners resort to English-NL CS when interacting among themselves, both in and outside the classroom. Using a qualitative study, I explore the language(s) of learners during group-work in the language, literacy and communication: English (LLCE) classroom, and show how their use of CS contributes to the achievement of the specific outcomes of this learning area within the outcomes-based education curriculum. I argue that even though CS is mostly prohibited in the classroom, its strategic use by learners serves as a means of fulfilling both social and pedagogical functions. [ABSTRACT FROM AUTHOR]

Various health promotion strategies have been implemented in South Africa aiming to encourage young people to talk about issues of sexuality and HIV with their parents/caregivers. Although parent/caregiver sexual communication may be an effective method of influencing sexual behaviour and curbing the incidence of HIV, very little is known about how young people with disabilities in South Africa communicate about these traditionally difficult subjects with their parents/caregivers. Based on findings from a participatory study conducted amongst 15–20-year-old Zulu-speaking youth with physical and visual disabilities, this paper explores how they perceive youth–parent/caregiver communication about sexuality and HIV. Using Foucauldian discourse analysis, the paper outlines how disabled youth–parent/caregiver sexual communication is governed by cultural customs, sexual secrecy and constructs of innocence. It also argues that the experiences and perceptions of young people with disabilities are critical to the development of future interventions to assist parents/caregivers develop communication strategies that help disabled young people make sense of sexual behaviour. [ABSTRACT FROM PUBLISHER]

The mental health care environment is a stressful environment, especially among student nurses. The purpose of the study was to develop a model of emotional support for student nurses working in the mental health care environment. The objectives were set in two phases: Phase one -- identification of concepts; Phase two -- development of a model of emotional support for student nurses. A theory-generating design, based on a qualitative, explorative and descriptive research approach, was used to meet the aim of the study. Data was purposively collected from 40 nursing students using (n=6) focus group discussions and eight educators and nine clinical staff by way of semi-structured interviews. Data was analysed by means of Tesch's method of data analysis. The model was developed by means of the four steps of which the first two are discussed in this paper as step three and four will be discussed elsewhere. Step one is the concept development consisting of concept identification and concept definition. A total of 22 concepts were identified, which were synthesised into six main concepts, namely, positive self-concept, positive work environment, academic and professional development, effective communication, formal and informal supportive interventions, and collaboration between the higher education institution and the mental health care setting. Step two is the model development during which the main concepts were placed in relation to one another, which formed an emotional support model for students working in mental health care settings. This paper gives an account of the methodological processes that were utilised to meet the aim and objectives of the study. [ABSTRACT FROM AUTHOR]

This study investigates the impact of social media as a strategic approach to corporate communication when handling crises at Bank X in the Gauteng province of South Africa. The study had three over-arching objectives; to determine the challenges that are encountered when handling crises about communication at Bank X, to determine if the leadership has the willingness to change their approach when formulating the strategy; to determine if social media has an impact on strategy formulation of crisis communication at Bank X; and lastly to make recommendations to Bank X's leadership on how to incorporate the social media component as a communication approach to effectively handle crises. This research followed a qualitative research approach through one-on-one Microsoft Teams in-depth interviews with 10 participants. The study, through the analysis of the primary data, secondary data, and literature reviews, underpins and supports that there is an opportunity for Bank X to incorporate social media as a strategic element to the crisis communication strategy. The organisation's crisis communication strategy needs to incorporate social media from a strategic perspective for it to be ahead of the curve when a crisis emerges online. The implications for Bank X are a lesson in the evolution of technology in the communication space and how imperative it is for the bank to evolve. [ABSTRACT FROM AUTHOR]

South African schools are tasked with providing sexuality education through the Life Orientation curriculum as a means of challenging continued high rates of HIV, unwanted pregnancy and gender-based violence. While in theory schools are well positioned to provide appropriate knowledge for reproductive health and navigating sexual challenges within a gender justice framework, research on sexuality education in South African schools indicates that this is not the reality in practice. This paper draws on a growing body of qualitative studies, with both educators and learners in South African schools, to understand the issues undermining the goal of a critical and social justice pedagogy of sexuality in Life Orientation classrooms. We argue that sexuality education has been deployed to regulate and discipline young sexualities, reinforce and perpetuate gender binarisms and heteronormativity, re-establish global northern family values of the nuclear family within a pro-family discourse, and represent continued assumptions of adult authority in a civilising mission over young people. We suggest that the failure to make critical use of Life Orientation is linked to the dominance of 'expert'-based didactic pedagogy, and argue the possibilities of sexuality education as a productive space for young people's active participation and agency in making meaning of gender and sexualities. [ABSTRACT FROM AUTHOR]

Technological innovations are changing the face of nursing education, with teachers being expected to integrate best teaching practices in the classroom and to ensure that nursing students are motivated and engaged. Taking into consideration students' needs is essential to provide successful integration of the technology in teaching and learning. This paper aims to explore nursing students' perceptions and expectations regarding the use of technology in nursing education. A descriptive quantitative research design was used, and the study was conducted at a selected university in South Africa. A total of 150 nursing students completed the questionnaires, with the data being analysed descriptively using SPSS version 25. The nursing students reported that educators used technology to deliver course instructions (96.7%), and encouraged students to use it for creative or critical thinking tasks (95.3%). They were encouraged by their educators to use their own technology devices (94.7%) and online platforms (94.7%). More undergraduate students perceived that nurse educators used technology at school (15.63 ± 2.54) than postgraduate students (14.41 ± 3.07) (U =1341.00, p = .044). Overall, 77.3 per cent of the nursing students expected the use of technology in teaching, mainly Moodle (88.7%), search tools (75.3%), podcasts and videocasts (66.7%), EndNote (62.7%), and Turnitin (48.7%). The majority of the students (82.1%) from the lower academic levels (first and second year) had a high expectation of the use of technology compared to 71.2 per cent of the higher levels (third and fourth year). The use of technology in teaching requires nurse educators to have adequate skills to make it a powerful tool for teaching and learning. Much more effort should be put in motivating students to use various technological tools, and ensuring that they have adequate skills, particularly at the entry level. [ABSTRACT FROM AUTHOR]

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

Background: Ensuring protocol visit compliance and maintaining high participant retention remain critical elements of clinical trials. In the HVTN 702 HIV vaccine trial, Setshaba Research Centre in Soshanguve, Tshwane, South Africa, experienced challenges in communicating with participants to remind them about their study visits. In order to improve participants adhering to their study visits, and study retention, we aimed to identify challenges in mobile communication, and to establish preferences in communication methods and interest in receiving study information via cellphones. Methods: We conducted a paper-based survey among HVTN 702 HIV vaccine trial participants at Setshaba Research Centre. The survey comprised of dichotomous and scale questions and was completed voluntarily and anonymously. The questions included those on their primary form of communication (calling, SMS and WhatsApp), the best time of day for the site to communicate with them, whether they were interested in receiving regular general study information updates via their cellular phone, how often they changed their cellular phones and/or network, whether they experienced any challenges with their cellular phones and what these challenges were, if any. All participants scheduled to visit the clinic from February to May 2019 were invited to participate. Thus, 90 of 380 (24%) participants enrolled by May 2019 were surveyed. Results: The majority (68%) of participants were 26−35 years old and almost three-quarters (73%) were female. Almost all participants (99%) had a personal cellphone. Half of the participants experienced some challenge related to cellphones, these being poor network signal at home (12%), battery running flat frequently (11%), sharing their phone (9%), lack of data (9%), challenges with use of applications (6%) and their cellphones being unreliable (3%). Annually, 20% of participants made a single or multiple network changes. Communication preferences were calls by site staff (80%), SMS (16%) and WhatsApp (3%). Most preferred to be contacted in the morning (49%) or afternoon (31%). Site contact was rated as 'very helpful' (87%), and 97% were interested in receiving regular general study information updates via their cellphone. Conclusion: Despite participants owning cellphones, there are still technical challenges, for example, network signals, battery-charging and applications. The majority of participants preferred being called rather than communicating by text messages or WhatsApp. Future studies need to include addressing participant challenges in maintaining contact and training of participants on use of cellphone applications to optimise communication. Noting the preferred time of day for participants to be called might improve the likelihood of making contact with them. The willingness to receive updates will aid in keeping participant interest high and enhance retention. [ABSTRACT FROM AUTHOR]

Background: The discontinuation of "Mother-Baby Friendly" accreditation, coupled with the impact of the COVID-19 pandemic, has contributed to reduced breastfeeding rates observed in parts of South Africa. Consequently, the Child, Youth and School Health cluster of the National Department of Health, with support from the World Health Organization and United Nations Children's Fund, organised a Mother-Baby Friendly initiative revitalisation workshop. Methods: Held in Johannesburg, South Africa, on June 29–30, 2022, the workshop brought together local and international breastfeeding promotion experts to engage on issues related to the revitalisation of the Mother-Baby Friendly Initiative. The workshop included presentations and group sessions aimed at setting expectations, evaluating the Ten Steps to Successful Breastfeeding, and developing actionable revitalisation strategies. Results: Inadequate monitoring of the Mother-Baby Friendly Initiative implementation and adherence to the Ten Steps was identified as a major implementation bottleneck. Participants identified steps ten (coordinating discharge so that parents and their infants have timely access to ongoing support and care), five (supporting mothers to initiate and maintain breastfeeding and manage common difficulties), and two (ensuring that staff have sufficient knowledge, competence, and skills to support breastfeeding) of the Baby-Friendly Hospital Initiative as the most difficult to implement. Step seven (enabling mothers and their infants to remain together and to practise rooming-in 24 h a day) was the least difficult to implement. Workshop participants identified the following proposed solutions to revitalise breastfeeding promotion: strengthening capacity building and mentorship, improving monitoring and accountability measures, and certification of facilities meeting the initiative's standards. Conclusion: Current breastfeeding policies and practices must be evaluated by the National Department of Health in collaboration with provincial and private representatives of the initiative to effectively revitalise the Mother-Baby Friendly Initiative. Moreover, an integrative monitoring framework must be developed through stakeholder engagement, role clarification, and ownership. While collaboration between the private and public sectors is required to promote training and communication within healthcare facilities and communities. [ABSTRACT FROM AUTHOR]

Both risk analysis and risk management are required for answering today's challenging construction project demands. The targeted result of combining risk analysis with risk management is a successful project, which satisfies the expectations of its stakeholders. This paper aims to assist geotechnical professionals with extending from traditional risk analysis towards risk management, by presenting some experiences and guidelines. These are derived from geotechnical practice and ongoing geotechnical risk management research, which actually takes place in The Netherlands. It also integrates professional experiences from a number of other countries, such as China, the United States, the United Kingdom and South Africa. The paper starts by defining and describing the concepts of risk analysis and risk management, while stressing that both complement each other. Risk analysis and risk management are blended in one geotechnical risk management framework: the GeoQ risk management process. The anticipated (financial) benefits of applying risk management are also highlighted. Next, some common barriers are presented, which may prevent geotechnical professionals from extending their activities to risk management. These barriers can be lowered, and under certain circumstances can even be eliminated. However, this will require the professional's motivation to apply risk management and the availability of at least some risk management tools. In addition, it is likely that some kind of training will be needed for gaining the attitude and skills for applying risk management. Non-geotechnical decision makers turn up in any construction project and they ultimately determine the amount of resources, such as money and time, to be allocated to geotechnical activities. By gaining risk management skills, in addition to in-depth geotechnical expertise, geotechnical professionals may become even better positioned to effectively communicate and implement their precious geotechnical expertise in any construction project. [ABSTRACT FROM AUTHOR]

Purpose-The purpose of this paper is to explore the management of employment equity (EE) communication at corporate level, against the background of South African societal complexities. It speculates about how the normative ideals of transformational change communication could be applied in order to bridge the apparent divide between government's current development agenda and negative societal sentiments about EE per se on the one side, and corporate transformation efforts on the other. Design/methodology/approach-A multiple qualitative case study design was followed for the collection of empirical evidence. Semi-structured interviews were used for data collection in each of the three case studies. Findings-This paper indicates current trends pertaining to the complexity of communicating EE in South Africa, including the strategic value of communication. It appears that internal communication does not receive as much strategic attention as external communication does. Furthermore, some key organizational leaders (involved in EE strategy implementation) view communication as a tactical tool and not a strategic means, thereby failing to appreciate either their own leadership responsibilities, or the complex nature of transformation change communication per se. These findings confirm the need for a new breed of transformational leaders who can conceptually and practically navigate the societal and corporate complexities surrounding EE communication in the management of change in South Africa. Originality/value-The paper stresses the complexity of transformational change communication against the background of societal and corporate reactions to EE in South Africa.

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Communication issues occur when foreign doctors from different cultural backgrounds have to treat local patients and attempt to establish rapport across cultures in order to diagnose correctly and advise treatment in a way that is acceptable to the patient. This paper reports on strategies used by Iranian and Nigerian medical doctors in public hospitals in Limpopo, South Africa, to establish and manage rapport in the opening sequence of their first meetings with local rural patients. The study used a conversation analysis method to examine the interaction of Iranian and Nigerian doctors with local South African patients against the background of Spencer‐Oatey's rapport management framework and cultural maxims of greetings and forms of address in the two countries. Recordings of opening sequences of consultations were examined to provide an understanding of the doctors' linguistic behavior. Consultations conducted by six doctors were recorded, transcribed, translated where necessary and analyzed against the background of the Rapport Management Framework. All the Iranian doctors were found to adopt different strategies from the Nigerian doctors even though both countries are classified as high‐context cultures and would be expected to use similar communication strategies. The findings have implications for the induction of foreign medical doctors in South Africa. [ABSTRACT FROM AUTHOR]

Communication has evolved into a cornerstone of central bank design and policy implementation. The South African Reserve Bank has been proactive in this regard as well – most notably with the adoption of inflation targeting in 2001. Using novel text-mining techniques, we evaluate the communication of the SARB, as presented via public speeches and monetary policy committee (MPC) statements, in the context of historical developments from 1994 to 2020. Our analysis focuses on the volume, complexity, scope, and sentiment of communication. We conclude that MPC statements are consistently and narrowly focused on the mandate, whereas speeches capture more detail about how the thinking of SARB policy makers evolves over time. In both cases, communication serves as a channel to reduce uncertainty and build credibility in the public domain. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate whether the content of Corporate Social Responsibility (CSR) messages predicts communication outcomes in South African nonprofit organisations (NPOs). The study found a positive association between CSR message content and CSR communication outcomes. Additionally, CSR message content in nonprofit organisations is positively linked to their CSR communication outcomes. Furthermore, support for community-related activities positively impacts CSR communication outcomes, thereby explaining the correlation between CSR message content and communication effectiveness. The study lays the groundwork for non-profit organisations seeking optimisation of their CSR messaging to achieve a wider socio-economic impact on the public at large. These results underscore the importance for nonprofit organisations to strategically develop CSR messages that highlight their support for community-related activities. By emphasising such content in their communication efforts, organisations can enhance their CSR communication outcomes, potentially fostering stronger relationships with stakeholders and garnering increased support for their initiatives. [ABSTRACT FROM AUTHOR]

Born a Crime: Stories from South African Childhood is a captivating memoir penned by a globally acclaimed South African comedian, Trevor Noah, delving into the hardships he and those around him endured during the oppressive Apartheid-era government and colonialism. This article analyzes instances where the comedian author employs a self-deprecating humour style to add depth to his narrative of stories from South African childhood. To conduct this analysis, we adopt cognitive and incongruity theoretical frameworks. Our methodology is qualitative, involving the analysis of selected texts to present thematic data. The findings reveal that the author's transparency about his life, from the title of the book to his relationships with others, delves into painful details of his childhood experiences during the traumatic history of the nation in which there was oppression. However, he presents these experiences with selfdeprecating humour that simultaneously entertains and educates readers about the socioeconomic issues prevalent in South Africa at the time. Noah's storytelling strategy can be understood within the context of comedians' freedom to explore sensitive matters about themselves to entertain their audience. [ABSTRACT FROM AUTHOR]

This paper aims to determine the feasibility of deploying free-space optical communication (FSOC) technology in South Africa. In order to achieve this aim, visibility, wind speed, and altitude data for several potential deployment locations over a period of 4 years have been used to compute the FSOC-based atmospheric losses under average and worst case atmospheric conditions. Results have shown that Ermelo has the highest optimal FSOC link distance of 7.5 km at an overall atmospheric loss of 2.8 dB under average conditions, while Durban has the shortest FSOC link distance at 2.6 km at an overall atmospheric loss of 12 dB under worst case conditions. It has also been found that the refractive index structure parameter is mainly altitude dependent. The parameter is larger at lower altitudes due to the more significant heat transfer between the air and the surface. Overall, this study has shown that FSOC technology deployment in South Africa is largely feasible (i.e., deployable with good reliability) for last mile broadband access networks, where link distances between transceivers measure 10 km on average. These results have been based on theoretical models, which take into account reasonable realistic assumptions of worst case atmospheric and the transceiver system parameter losses. [ABSTRACT FROM AUTHOR]

This paper aims to evaluate the impacts of four communication programs on promoting HIV testing behavior among sexually active individuals in South Africa. The four programs, implemented by Johns Hopkins Health and Education in South Africa, are aimed to promote HIV prevention behaviors, as well as gender-based violence prevention, tuberculosis screening and treatment, and reduction of alcohol consumption. Launched between 2009 and 2010, they all promoted HIV testing. Data came from the population-based Third National AIDS Communication Survey 2012; 6004 men and women who had sex within the last 12 months were included in the analysis. Multiple causal attribution analysis is used to justify causal reference and estimate the impact of communication programs. Findings indicate significant direct and indirect effects of the programs on HIV testing behavior. Indirect effects worked through increasing one's likelihood of perceiving that their friends were tested and the probability of talking about HIV testing with sex partners and friends, which in turn increased the likelihood of HIV testing. Findings suggest multiple angles from which communication programs can promote HIV testing. The study also demonstrates the use of multiple statistical techniques for causal attribution in a post-only design, where randomization is not possible.

Purpose: Based on the bioecological model by Bronfenbrenner, this paper will provide a broad perspective on factors that need to be taken into account in order to facilitate communication and participation in preliterate children making use of electronic Augmentative and Alternative Communication (AAC) systems accessed through eye gaze. Method: Two case studies of children who have been provided with the technology described are presented. The case studies were analysed using the four nested systems of the ecology as a framework to describe not only the environment, but also the processes and interactions between the persons and their context. Results: Risk and opportunity factors are evident at all levels of the ecology. Conclusions: While a good fit between the person and the technology is an essential starting point, additional factors pertaining to the partner, the immediate environment as well as meso-, exo- and macrosystemic issues (such as societal attitudes and funding sources) have a significant influence on benefits derived. In resource-limited environments, the lack of support at more distal levels of the ecology (meso-, exo- and marosystemic levels) seems to be a factor that differentiates these environments from more resourced ones. [ABSTRACT FROM AUTHOR]

Social capital is increasingly conceptualised in academic and policy literature as a panacea for a range of health and development issues, particularly in the context of HIV. In this paper, we conceptualise social capital as an umbrella concept capturing processes including networks, norms, trust and relationships that open up opportunities for participation and collective action that allow communities to address issues of common concern. We specifically outline social capital as comprising three distinct forms: bonding, bridging and linking social capital. Rather than presenting original data, we draw on three well-documented and previously published case studies of health volunteers in South Africa. We explore how social contexts shape the possibility for the emergence and sustainability of social capital. We identify three cross-cutting contextual factors that are critical barriers to the emergence of social capital: poverty, stigma and the weakness of external organisations' abilities to support small groups. Our three case studies suggest that the assumption that social capital can be generated from the ground upwards is not reasonable. Rather, there needs to be a greater focus on how those charged with supporting small groups--non-governmental organisations, bureaucracies and development agencies--can work to enable social capital to emerge. [ABSTRACT FROM AUTHOR]

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

Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private) in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36). Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semistructured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results: The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers' recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion: The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision of consistent and high-quality patient care. [ABSTRACT FROM AUTHOR]

Background: Lay health workers (LHWs) are critical in linking communities and primary healthcare (PHC) facilities. Effective communication between facilities and LHWs is key to this role. We implemented a mobile health (mHealth) system to improve communication and continuity of care for chronically ill clients. The system focused on requests from facility staff to LHWs to follow up clients and LHW referrals of people who needed care at a facility. We implemented the system in two rural and semi-rural sub-districts in South Africa. Objective: To assess the feasibility of the mHealth system in improving continuity of care for clients in PHC in South Africa. Method: We implemented the intervention in 15 PHC facilities. The clerks issued recalls to LHWs using a tablet computer. LHWs used smartphones to receive these requests, communicate with clerks and refer people to a facility. We undertook a mixed-methods evaluation to assess the feasibility of the mHealth system. We analysed recall and referral data using descriptive statistics. We used thematic content analysis to analyse qualitative data from semi-structured interviews with facility staff and a researcher fieldwork journal. Results: Across the sub-districts, 2,204 clients were recalled and 628 (28%) of these recalls were successful. LHWs made 1,085 referrals of which 485 (45%) were successful. The main client group referred and recalled were children under 5 years. Qualitative data showed the impacts of facility conditions and interpersonal relationships on the mHealth system. Conclusion: Using mHealth for recalls and referrals is probably feasible and can improve communication between LHWs and facility staff. However, the low success rates highlight the need to assess facility capacity beforehand and to integrate mHealth with existing health information systems. mHealth may improve communication between LHWs and facility staff, but its success depends on the health system capacity to incorporate these interventions. [ABSTRACT FROM AUTHOR]

Globally, communication plays an integral role in public health strategies, from infectious diseases to diseases related to lifestyles. The evolution of the field of social and behaviour change communication (SBCC), combined with the need for evidence based practice and multi-level interventions to promote health, and human resource gaps in sub-Saharan Africa have led to the imperative to standardise and formalise the field. Moreover, current practitioners come from different disciplinary backgrounds underlining the need to define common core skills and competencies. This paper describes the partnership between the Wits School of Public Health and the Soul City Institute for Health and Development Communication and how the partners responded to this need. It highlights the factors influencing sustainable institutional capacity to provide quality assured, accredited training. We describe an unexpected positive response from a number of practitioner organisations that have chosen to send multiple staff members for training, specifically to build a critical mass within their organisations. Finally, we note the interest from (mostly) southern-based academic institutions in setting up similar programmes and postulate that south-south collaborations can contribute to building sustainable context specific and evidence-informed SBCC programmes in the global south.

Objective: In health interactions which require an interpreter, there are occasions when there are uninterpreted asides between participants. These are often construed to be features which hinder the interpreting process. However they have potential to yield critical information in certain health care contexts., Methods: This paper examines 17 instances of asides in interpreted interactions which took place in 3 intercultural health care contexts in South Africa. The asides were transcribed, translated and analysed based on conversation analysis principles., Results: The topics of the asides as well as who initiates them appear highly dependent on contextual features. There is evidence for the emergence of 'small talk' which serves the purpose of framing comfort levels, aligning the interpreter and patient or offering guidance for example, and the emergence of 'big talk' or engagement on topics which for cultural and historical reasons and power imbalances between the health practitioner and patient may be too difficult to raise directly. Such information also yields critical diagnostic and therapeutic information., Conclusion: Our findings suggest evidence for the presence of multiple patterns and roles that the interpreter may assume in such interactions., Practice Implications: Implications for team training and practice are provided., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)