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Public financing of education in the developing world context combines public and private funds, and the utilisation of fees is seen as a way of complementing state resources. In South Africa the new government in 1994 permitted schools to charge fees, a policy that has provoked much controversy. While different aspects of this policy have been well documented, less is known about the decision to review this policy and declare certain schools as no-fees schools in 2006. This paper addresses this gap by reviewing the current no-fees schools policy and its potential impact on the South African education system. Specifically it examines whether the amended policy promotes school access for the poor while creatively complementing state resources. It is argued that while the policy is a progressive step away from charging fees for basic education, there are a number of policy challenges that require further reflection and research. (Contains 3 tables and 2 notes.)

American and French law, like South African law, recognises claims for emotional or mental harm. Emotional, mental or psychological harm was recognised by the courts only in the nineteenth century and even though the mind and body in a sense are considered as a unit, these types of claims are not on a par with claims for physical bodily injury. Finding delictual or tort liability for emotional, mental or psychological harm has been problematic not only in South Africa but also in the United States of America and France. Even though there are fundamental differences in the law between these jurisdictions, the broader questions the courts face is whether a claimant is entitled to claim, the amount of damages that should be awarded and how to limit liability with this type of claim. Limiting liability for emotional or mental harm is generally the main concern but the courts have found ways of using the elements of a delict or tort, or concepts such as reasonable foreseeability of harm to limit the claims. American, French and South African law recognise claims for emotional, mental or psychological harm sustained by primary and secondary victims. Thus emotional, mental or psychological harm caused directly or indirectly is compensable. In American and French law the concept of reasonableness plays an important role, whether it be implicit or explicit, in determining delictual or tort liability for the emotional or mental harm sustained. In a sense, reasonableness also plays an overarching role in determining liability. The influence of reasonableness in determining delictual or tort liability for psychiatric or psychological harm in English and South African law will be discussed in a forthcoming contribution. In this contribution the focus is on the influence of reasonableness in determining delictual or tort liability for emotional or mental harm in American and French law. [ABSTRACT FROM AUTHOR]

Due to a lack of authority in Roman-Dutch law in respect of claims for psychological harm, our courts in South Africa relied on English law for guidance, in particular the tort of negligence, where emphasis is placed on reasonable foreseeability of harm. The courts in both jurisdictions generally face challenges with who exactly is entitled to claim, the quantification of the damages that should be awarded and how to limit delictual or tort liability emanating from these types of claims. South African law also followed English law in making the distinction between primary and secondary victims and as will be shown in this contribution, limiting liability in respect of secondary victims is problematic. The courts generally tread with caution in awarding damages for pure psychological or psychiatric harm and several policy considerations are taken into account when deciding to award damages or not. Nevertheless, as will be shown in this contribution, the courts in South Africa and the United Kingdom acknowledge these claims and have been developing the law around the cases that have come before them. What is rather interesting and prevalent, though, with regard to primary and secondary victim claims for psychological or psychiatric harm in these jurisdictions, is the implicit and explicit influence of "reasonableness" in determining delictual or tort liability for these types of claims. This will be pointed out further in this contribution. [ABSTRACT FROM AUTHOR]

In this contribution the influence of reasonableness on the element of conduct in the South African law of delict will be analysed and compared with the requirement of some form of conduct in English tort law, American tort law and the French law of delict. Fundamental similarities and differences among the different legal systems must be considered. France and South Africa follow a generalising approach to determining a delict while English and American law have a system of separate torts. Even though English and American law do not explicitly refer to the requirement of conduct in tort law, it is generally implicitly required. This is the case whether one is dealing with the tort of negligence or the intentional torts. In French law too, a fait générateur (a generating, triggering, wrongful act or event) generally must also be present in order to ground delictual liability. The concept of fait générateur is broader than the concept of conduct found in the other jurisdictions in that it extends beyond what is regarded as human conduct. The conduct in all the jurisdictions may be in the form of a commission (a positive, physical act or statement) or an omission (a failure to act). The requirement that conduct must be voluntary is generally found in South African, English and American law (with an exception applying to mentally impaired persons) but not in France. Naturally, it is unreasonable to hold a person liable without conduct which results in the causing of harm or loss. In all the above-mentioned jurisdictions, it would generally be unreasonable to hold the wrongdoer liable in delict or tort law if the omission or commission does not qualify as some form of conduct. Thus the influence of reasonableness on the element of conduct in all the above-mentioned jurisdictions is implicit. [ABSTRACT FROM AUTHOR]

Abstract: Background: Burns are a global public health problem. In South Africa, the rate of paediatric burn deaths is 5 times higher than other upper middle‐income countries, with concentrations in impoverished settings. Globally, the majority of research focuses on expert and caregiver descriptions of burn occurrence, causation, and prevention, with limited consideration of children's perspectives. This study investigated children's understanding of the causation and prevention of childhood burns. Methods: Data were collected from eighteen 10‐ to 11‐year‐old children living in selected impoverished, fire‐affected neighbourhoods in Cape Town, through 3 isiXhosa focus groups. All focus groups were transcribed, coded, and analysed for emerging themes through thematic analysis. Results: Themes regarding burn causation and risks centred around 4 themes: (a) developmental limits in context; (b) domestic chores, child capacity, and inability to say “no”; (c) inadequate supervision and compromised caregiving; and (d) unsafe structures. Child accounts of prevention pertained to (e) burn injury prevention activities in comprised environments and emphasized child agency, and upgrading the physical environment. Conclusion: The children in this study ascribed burn injuries as the consequence of their developmental limits in the context of poverty, constraints on parental supervision, and unsafe environments. The children recommended safety education and upgrading their physical environments as part of burns injury prevention. The child accounts offer useful insights to inform safety interventions in impoverished settings. [ABSTRACT FROM AUTHOR]

Objectives: Carotid intima-media thickness (CIMT) is a surrogate marker of subclinical atherosclerosis and a predictor of cardiovascular events. Few studies in Africa have evaluated CIMT and its associations in people with type 2 diabetes mellitus. This study measured CIMT in a sample of mainly black South African patients with type 2 diabetes mellitus, and evaluated the association of demographic and clinical risk factors with CIMT. Design: Cross-sectional study. Setting: Kafalong Hospital, a large community hospital in Pretoria that mainly serves an urban black community. Subjects: Patients with type 2 diabetes mellitus. Outcome measures: We evaluated clinical, biochemical and CIMT ultrasound measurements in a standardised fashion. Results: In 185 patients, the univariate significant predictors of mean far-wall CIMT were age [beta 0.007 (standard error 0.001)], systolic blood pressure [beta 0.001 (standard error 0.000)] and inverse serum creatinine [beta -8.15 (standard error 3.23)]. Low-density lipoprotein cholesterol, apolipoprotein A-1, apolipoprotein B:A-1 ratio and apolipoprotein B:A-1 ratio > 1.2 all had p-values below 0.1, but above 0.05. Age had the largest R-squared (20%). The multivariate models did not explain more of the variation in CIMT than did age alone. Conclusion: Lipid parameters were related to CIMT in our study population. However, this did not reach statistical significance in this relatively small sample, and lipids added very little to the variability of CIMT compared with age alone. [ABSTRACT FROM AUTHOR]

Gender-based violence is a widespread problem in South Africa. Past structural inequities have created a climate conducive to violence against women. As an initial step toward developing a health promotion program, we conducted exploratory formative research to examine the barriers that affect the health and well-being of youth. Fourteen focus groups (nine with girls and five with boys) were conducted with 112 adolescents in a racially mixed community on the outskirts of Cape Town, South Africa. We utilized grounded theory and thematic analysis to examine the data. The impact of poverty, ubiquitous gendered violence, transactional sex and unsafe recreational spaces emerged as the major themes. The experiences of youth were consumed by issues of safety rather than the pursuit of other developmentally appropriate markers. Our findings suggest that health promotion programs should create safe spaces for youth and opportunities to critically question the assumptions and manifestations of a patriarchal society. Furthermore, the findings indicate that there is a strong need for multi-sectorial interventions directed at many levels to prevent gender-based violence. [ABSTRACT FROM AUTHOR]

The article discusses the amendments made to section 17 of the Road Accident Fund (RAF) Act of South Africa as well as presents the procedures to be adopted in a claim for non-patrimonial loss against the RAF. It mentions the adoption of the changes aimed at putting the RAF on a more financially sound footing, ensuring its sustainability, minimizing costs in terms of paying out legal fees and addressing inequality. Further, the changes reflect on the jurisdiction to rule on whether or not a claimant's injuries are regarded as serious for the purposes of claiming such loss and the determination of the American Medical Association (AMA) Impairment Rating with regard to the determination of serious injury.

Public financing of education in the developing world context combines public and private funds, and the utilisation of fees is seen as a way of complementing state resources. In South Africa the new government in 1994 permitted schools to charge fees, a policy that has provoked much controversy. While different aspects of this policy have been well documented, less is known about the decision to review this policy and declare certain schools as no-fees schools in 2006. This paper addresses this gap by reviewing the current no-fees schools policy and its potential impact on the South African education system. Specifically it examines whether the amended policy promotes school access for the poor while creatively complementing state resources. It is argued that while the policy is a progressive step away from charging fees for basic education, there are a number of policy challenges that require further reflection and research. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Dietary starch that escapes digestion in the small intestine may be quantitatively more important than dietary fiber as a substrate for fermentation. The products of fermentation have important implications in the pathogenesis of colorectal cancer and other diseases of the large bowel, which are uncommon in Africans but have a high prevalence in Western populations. METHODS: Maize porridge is a staple of most blacks in South Africa. Stale maize porridge (high-resistant starch [HRS]) seems to induce greater fermentation in the large bowel than fresh maize porridge (low-resistant starch [LRS]). RESULTS: In the present study, healthy colostomy subjects fed stale maize porridge had significantly more production of short-chain fatty acids (SCFA) (mean SCFA, HRS = 182.6; mean SCFA, LRS = 116.1; p < 0.05) in their colostomy effluent together with a significant drop in stool pH (mean pH, HRS = 5.91; mean pH, LRS = 6.70; p < 0.001). The SCFA butyrate (mean, HRS = 35.1; mean, LRS = 17.6; p < 0.05) and acetate (mean, HRS = 93.9; mean, LRS = 65.8; p < 0.05) were significantly elevated on the stale maize porridge diet when compared with consumption of fresh maize porridge. SCFA propionate (mean, HRS = 43.1; mean, LRS = 24.8; p = 0.05), also increased with stale maize porridge, but was not statistically significant. CONCLUSION: A high-resistant starch diet and its resultant increase in fermentation products may be partly responsible for protecting the black population against colorectal cancers and other large bowel diseases. [ABSTRACT FROM AUTHOR]

Background: South Africa (SA) has a high prevalence of HIV and tuberculosis. Cape Town was the SA metropole most affected in the early stages of the COVID-19 pandemic. Early observational data from Africa may provide valuable insight into what can be expected as the pandemic expands across the continent., Objectives: To describe the prevalence, clinical features, comorbidities and outcome of an early cohort of HIV-positive and HIV-negative patients admitted with COVID-19., Methods: This was a descriptive observational study of an early cohort of adults with COVID-19 pneumonia admitted from 25 March to 11 May 2020., Results: Of 116 patients (mean age 48 years, 61% female) admitted, 24 were HIV-positive (21%). The most common symptoms reported were cough (n=88; 73%), shortness of breath (n=78; 69%), fever (n=67; 59%), myalgia (n=29; 25%) and chest pain (n=22; 20%). The most common comorbidities were hypertension (n=46; 41%), diabetes mellitus (n=43; 38%), obesity (n=32; 28%) and HIV (n=24; 21%). Mortality was associated with older age (mean (standard deviation) 55 (12) years v. 46 (14) years; p&lt;0.01); the presence of hypertension or hypertension along with diabetes and/or obesity; lower partial pressure of arterial oxygen to fraction of inspired oxygen ratio; and higher urea level, white cell count, neutrophil count, and C-reactive protein, lactate dehydrogenase and ferritin levels, and high neutrophil to lymphocyte ratio. The overall survival rate for all hospital admissions was 86/116 (73%). In this early cohort, survival was similar in patients with HIV (n=18; 75%) compared with those without HIV (n=67; 75%) (p=1). Of the 74 patients admitted to the wards, 63 (85%) survived, whereas 22 of 42 (52%) admitted to the intensive care unit survived., Conclusions: Patients with HIV infection represented a large proportion of all COVID-19 admissions. The presentation and outcome of patients with HIV did not differ significantly from those of patients without HIV.

Cancer is one of the leading causes of death worldwide. A major reason why women do not obtain cancer screening procedures relates to the high levels of fear associated with cancer. In this study, we explored South African mothers' and daughters' reaction to the word "cancer" specifically. The study sample included 157 randomly selected mother and adolescent daughter pairs from an urban community in Cape Town, South Africa. Mothers and their adolescent daughters had very similar responses to the term "cancer." We found that most South African mothers and daughters had a fear-based attitude toward the illness. When we asked mothers what they immediately thought of upon hearing "cancer," a majority of women (69%) thought of death, and another 43% thought of suffering and the detrimental consequences of the illness. Similarly, 50% of the daughters also thought of death, and 42% thought of the detrimental aspects of cancer. Fatalistic attitudes and negative emotional reactions have important implications in cancer prevention and need to be addressed within a public health context.

Background: Recent literature has indicated that exposure to multiple traumatic events in adults is associated with high levels of posttraumatic stress disorder (PTSD), anxiety, and depression. Against the backdrop of stressful life events and childhood abuse and neglect, we investigated the cumulative effect of multiple trauma exposure on PTSD, anxiety, and depression in an adolescent sample., Method: One thousand one hundred forty 10th-grade learners from 9 Cape Town (South Africa) schools completed questionnaires on stressful life experiences; trauma exposure; and symptoms of anxiety, depression, and PTSD. Our population of interest for this study was adolescents between the ages of 14 and 18 years who had been exposed to serious, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, qualifying traumatic events. The final sample size was thus 922., Results: Rates of trauma exposure, PTSD, depression, and anxiety were high. Controlling for sex, stressful life experiences in the past year, and childhood adversity, we found an effect of cumulative trauma exposure effect on PTSD and depression, with an increase in the number of traumas linearly associated with an increase in symptoms of PTSD (F((4,912)) = 7.60, P < .001) and depression (F((4,912)) = 2.77, P < .05). We did not find a cumulative effect on anxiety., Conclusion: Our findings indicate that adolescents exposed to multiple traumas are more likely to experience more severe symptoms of PTSD and depression than those who experience a single event, with this effect independent of childhood adversity and everyday stressful life experiences. Exposure to multiple trauma, however, does not seem to be associated with more severe anxiety symptoms.