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Expanding floating wind into new markets could support emission reduction targets in several national contexts. It furthers the need for adequate assessments to gain a full understanding of the technology's potential in future markets. South Africa is a prime case study as it has seen limited industry and policy developments despite its huge technical potential for floating offshore wind (FOW). This paper assessed the locational potential of floating wind in South Africa through a three-phased approach that evaluated the key technical drivers/barriers of the technology, conducted a Geographic Information System analysis (GIS) using ArcMap 10.8 to exclude unsuitable sites based on a predetermined exclusion criteria (including marine protected zones, underwater cables, major oil and gas deposits, etc.), and estimated the total harvestable capacity in the feasible sites. The study found that 2% (246,105.4 km2) of South Africa's entire Exclusive Economic Zone (EEZ) is suitable for hosting floating wind turbines, with a potential to generate a maximum of 142.61 GW of floating wind power. Although the Western Cape province holds the highest potential (80.52 GW) for floating wind in the country, the Eastern Cape region, with a locational potential of 20.04 GW, is considered most suitable for early-stage developments due to the availability of grid connection points, limited marine traffic, and proximity to appropriate port facilities. Future work can conduct techno-economic assessments to evaluate the technical and economic implications of developing floating wind in distinct sites in the country's EEZ. [ABSTRACT FROM AUTHOR]

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The aim of stock assessment is to provide managers with an understanding of the biomass and age-/size-composition of a stock, stock status (ideally relative to target and reference points), and to support management decision making, often through projections and application of harvest control rules. Stock assessments are increasingly being used to form the basis for the operating models used to evaluate the ability of management strategies to achieve the goals of fisheries management. Stock assessments for rock lobsters were among the first to adopt size-structured population models as the basis for stock assessment, and population model-based stock assessments have been used extensively to evaluate management strategies for rock lobster stocks in the USA, Australia, New Zealand and South Africa. This paper identifies how closely population model-based stock assessments for rock lobsters satisfy the guidelines identified for best practices for conducting stock assessments during meetings of, for example, the Center for the Advancement of Population Assessment Methodology and papers identifying best practice guidelines for stock assessment. The paper highlights some key directions for stock assessment science for rock lobsters, including considerations related to environmental variation and climate change. [ABSTRACT FROM AUTHOR]

Koh-i-Noor and other world-famous diamonds such as Hope, Orloff, Great Mogul, Nizam, and Pitt, well-known in the industry as 'Golkonda Diamonds' are very well recognised for their rare colours, large carat sizes, and because of the paucity of nitrogen atoms majority of them have been classified as Type IIa diamonds. These renowned Golkonda diamonds were recovered from placers mined on the banks of the Krishna River in southern India; however, their primary source rocks (either kimberlites or lamproites) remain questioned and untraced. Precise identification of the primary sources of such large-sized, dominantly Type IIa diamonds (i.e., CLIPPIRS) is crucial for understanding their deep mantle origin, nature and timing of magmatism carrying them and essential from economic and geological perspectives. We employed a multidisciplinary approach incorporating xenocrystic mineral composition and bulk-rock geochemistry, field geological and remote sensing (GIS) studies to locate the probable primary sources of these renowned diamonds, know the origin of Type IIa Golkonda diamonds in southern India, and to understand the mechanism and timing of diamond transport and dispersal as placers in the Krishna River basin. Our study rules out the possibility of various lamproite occurrences of the Eastern Dharwar Craton and Banganapalle conglomerates as being sources of Koh-i-Noor and other Golkonda diamonds. The absence of Type IIa diamonds in the highly diamondiferous Late Cretaceous kimberlites of Wajrakarur likewise excludes them as source of Golkonda diamonds. Among southern India's two significant kimberlite fields, i.e., Wajrakarur and Narayanpet, compositions of indicator minerals from the Wajrakarur Kimberlite Field (WKF) reveal their ultimate diamond preservation potential, presence of strong diamondiferous mantle roots and deeper source regions, hence recognising them to be the potential sources of Golkonda diamonds. GIS and remote sensing tools were used to calculate moisture content, vegetation indices, and to locate paleo-channel of the Penner River, which was primarily responsible for the transportation of diamonds from their Mesoproterozoic (ca. 1.1 Ga) source rocks at Wajrakarur to their final sites of recovery, i.e., Kolluru and other mines situated on the banks of the Krishna River. The occurrence of alluvial placer deposits in Krishna River drainage system is analogous to the Orange River drainage system in South Africa. Both areas have diamonds sourced from primary kimberlite pipes, transported by rivers, and deposited in specific areas. Similarities in the origin, mechanism of diamond transport, dispersal and deposition have played a crucial role in significant diamond production from alluvial deposits in Krishna and Orange Rivers. [ABSTRACT FROM AUTHOR]

This research explores intra-gully sediment volume changes of a massive gully network (42 ha) located in the Eastern Cape, RSA, in response to high rainfall events during a three-year study period (2017–2020). Unmanned aerial vehicles (UAVs) and photogrammetric processing were used to generate high resolution digital surface models (DSMs). Volumetric calculations were run to estimate the extent of gully expansion within the system to determine intra-gully changes and sediment erosion over the study period. The gully was categorised into four zones based on predominant structure and processes. These are the Extension Zone, Expansion Zone, Transport/Deposition Zone and the Side Branches. Rainfall data from a rainfall station (10 km away) was used to investigate the correlation between rainfall depth, rainfall intensity, and flow accumulation over two wetter years and one drier year with gully expansion experienced during these periods. The gully network encountered a total gully sediment volume erosion of 104,489 m3 (6.01%) over the study period. Nineteen high to extreme intensity (>20 mm per day) rainfall events produced the runoff necessary for gully expansion during the 2017 and 2018 hydrological years. Notably, lower gully growth was recorded in the Expansion and Transport/Deposition Zones during the subsequent below average hydrological year in 2019–2020. [ABSTRACT FROM AUTHOR]

Ecosystems that offer carbon sequestration by leaching bicarbonate to groundwater are valuable natural capital. One region that may offer this service is the west coast of South Africa. Over 20 % is covered by soil mounds ("heuweltjies") up to 40 m diameter, 2 m high, inhabited by the southern harvester termite Microhodotermes viator and enriched in soil organic and inorganic carbon and soluble minerals. We aimed to generate radiogenic and stable isotope data for soils and groundwater in a region where these data are absent, to 1) verify the atmosphere-soil-groundwater link, and 2) resolve the timing and pattern of calcite dissolution and water infiltration in the landscape. Results show that soil and groundwater sulfate have the same marine aerosol source. Episodic calcite dissolution in mound centers, which increased during periods of global cooling, has been set against background input of marine aerosols since before the Last Glacial according to radiocarbon ( 14 C) ages. Our data push back soil organic carbon 14 C ages of inhabited termite mounds to 13-19 ka (kiloannum, thousand years before present), nest carbonate 14 C ages to 33 ka, and mound soil carbonate 14 C ages to 34 ka, making these the oldest active termite features ever dated. These ages are consistent with soil organic carbon and carbonate 14 C ages of regional, non-mound, coastal petrocalcic horizons formed by accumulation of carbonate leached from their overlying aeolian dune fields. Harvesting activities of termites inject younger organic material around nests >1 m deep, leading to continuous renewal of important soil carbon reservoirs at depth. Termite bioturbation increases the system's ability to dissolve carbonate. The central, bioturbated part of the mounds have greater infiltration depths and greater calcite dissolution, whereas surrounding soils experienced more surface runoff. Calcareous termite mounds offer a mechanism to sequester CO 2 through dissolution and leaching of soil carbonate-bicarbonate to groundwater., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Two field cases of reddish-black pigmenturia occurred where cattle grazed on an established Cenchrus ciliaris (blue buffalo grass) pasture in South Africa. The pasture was noticeably invaded by Indigofera cryptantha, which was heavily grazed. Apart from the discolored urine, no other clinical abnormalities were detected. Urinalysis revealed hemoglobinuria, proteinuria and an alkaline pH. When the animals were immediately removed from the infested pasture, they made an uneventful recovery. However, a bull died when one of the herds could not be removed from the I. cryptantha-infested pasture. Macroscopically, the kidneys were dark red in color and the urinary bladder contained the dark pigmented urine. Microscopically, the renal tubules contained eosinophilic, granular pigment casts in the lumen. In addition, many renal tubular epithelial cells were attenuated with granular cytoplasm and were detached from the basement membranes. Chemical analysis was performed on dried, milled plant material and two urine samples collected during the field investigations. Qualitative UPLC-UV-qTOF/MS analysis revealed the presence of indican (indoxyl-β-glucoside) in the stems, leaves and pods of I. cryptantha and indoxyl sulfate was identified, and confirmed with an analytical standard, in the urine samples. It is proposed that following ingestion of I. cryptantha, indican will be hydrolysed in the liver to indoxyl and conjugated with sulfate. Indoxyl sulfate will then be excreted in relatively high concentrations in the urine. In the alkaline urine, two indoxyl molecules might dimerize to form leucoindigo with subsequent oxidation to indigo, thus, contributing to the dark pigmentation of the urine. It is also possible that indoxyl sulfate contributed to the renal failure and death of the bull. Although I. suffruticosa-induced hemoglobinuria has been described in Brazil, this is the first report of I. cryptantha-induced pigmenturia in cattle in South Africa., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study reports the presence, concentration, and characteristics of microplastics (MPs) in tap water in three suburbs in Gauteng Province in South Africa. Physical characterisation was conducted using stereomicroscopy and scanning electron microscopy following staining of MPs with the Rose Bengal dye. The concentrations of MPs in all samples ranged from 4.7 to 31 particles/L, with a mean of 14 ± 5.6 particles/L. Small-sized (<1 mm) and fibrous-shaped MPs were most abundant in all samples. Fibers accounted for 83.1% of MPs in samples from all the three areas, followed by fragments (12.4%), pellets/beads (3.1%), and films (1.5%), with a minor variation in the distribution of shapes and sizes in samples from each area. Raman microspectroscopy was used for chemical analysis, and five polymers were identified, namely: high-density polyethylene, polyurethane, polyethylene terephthalate, poly(hexamethylene terephtalamide), and poly(acrylamide-co-acrylic acid). C.I Pigment Red 1, C.I. Solvent Yellow 4, Potassium indigotetrasulphonate, and C.I Pigment Black 7 were the colourants detected. These colourants are carcinogenic and mutagenic and are potentially toxic to humans. The prevalence of MPs in tap water implies their inadequate removal during water treatment. For instance, the presence of poly(AM-co-AA) suggests that drinking water treatment plants may be a potential source of MPs in tap water. Other polymers, e.g., high-density polyethylene may be released from pipes during the transportation of drinking water. The estimated daily consumption of MPs from tap water was 1.2, 0.71, and 0.50 particles/kg.day for children, men, and women, respectively. The findings of this study provide evidence of the presence of MPs in drinking water in South Africa, thus giving some insights into the performance of treatment plants in removing these contaminants and a benchmark for the formulation of standard limits for the amount of MPs in drinking water., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

A sensitive modified QuEChERS extraction method was developed to assess the levels of free and conjugated bisphenols (BPs) in human milk collected between 2018 and 2019 from two regions of South Africa (the Limpopo Province Vhembe district, n = 194; Pretoria, n = 193) and Canada (Montreal, n = 207). Total BPA (free and conjugated) and BPS were the predominant bisphenols detected in samples from Vhembe and Pretoria, whereas total BPS was the predominant bisphenol detected in Montreal samples. The levels of total BPA in samples from Vhembe and Pretoria ranged between < MDL-18.61 and

Foot-and-mouth disease is a controlled disease in accordance with the South African Animal Diseases Act (Act 35 of 1984). The country was classified by the World Organisation for Animal Health (WOAH) as having a FMD free zone without vaccination in 1996. However, this status was suspended in 2019 due to a FMD outbreak outside the controlled zones. FMD control in South Africa includes animal movement restrictions placed on cloven-hoofed species and products, prophylactic vaccination of cattle, clinical surveillance of susceptible species, and disease control fencing to separate livestock from wildlife reservoirs. The objectives of this study were to evaluate differences in identifying high-risk areas for FMD using risk factor and expert opinion elicitation analysis. Differences in risk between FMD introduction and FMD spread within the FMD protection zone with vaccination (PZV) of South Africa (2007-2016) were also investigated. The study was conducted in the communal farming area of the FMD PZV, which is adjacent to wildlife reserves and characterised by individual faming units. Eleven risk factors that were considered important for FMD occurrence and spread were used to build a weighted linear combination (WLC) score based on risk factor data and expert opinion elicitation. A multivariable conditional logistic regression model was also used to calculate predicted probabilities of a FMD outbreak for all dip-tanks within the study area. Smoothed Bayesian kriged maps were generated for 11 individual risk factors, overall WLC scores for FMD occurrence and spread and for predicted probabilities of a FMD outbreak based on the conditional logistic regression model. Descriptively, vaccine matching was believed to have a great influence on both FMD occurrence and spread. Expert opinion suggested that FMD occurrence was influenced predominantly by proximity to game reserves and cattle density. Cattle populations and vaccination practices were considered most important for FMD spread. Highly effective cattle inspections were observed within areas that previously reported FMD outbreaks, indicating the importance of cattle inspection (surveillance) as a necessary element of FMD outbreak detection. The multivariable conditional logistic regression analysis, which was consistent with expert opinion elicitation; identified three factors including cattle population density (OR 3.87, 95% CI 1.47-10.21) and proximities to game reserve fences (OR 0.82, 95% CI 0.73-0.92) and rivers (OR 1.04, 95% CI 1.01-1.07) as significant factors for reported FMD outbreaks. Regaining and maintaining an FMD-free status without vaccination requires frequent monitoring of high-risk areas and designing targeted surveillance., Competing Interests: Declaration of Competing Interest None of the authors has any financial or personal relationship that could inappropriately influence or bias the content of this paper. The National Research Foundation of South Africahttps://www.nrf.ac.za/ (NRF) provided partial funding for this study [grant numbers 90578, 76734]. NRF played no role in the study design nor in the collection, analysis and interpretation of data, nor in the decision to submit the manuscript for publication., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The World Health Organization (WHO) set up the messenger ribonucleic acid (mRNA) technology transfer programme in June 2021 with a development hub in South Africa and 15 partner vaccine producers in middle-income countries. The goal was to support the sustainable development of and access to life-saving vaccines for people in these countries as a means to enhance epidemic preparedness and global public health. This initiative aims to build resilience and strengthen local vaccine research, and development and manufacturing capacity in different regions of the world, especially those areas that could not access coronavirus disease 2019 (COVID-19) vaccines in a timely way. This paper outlines the current global vaccine market and summarizes the findings of a case study on the mRNA technology transfer programme conducted from November 2022 to May 2023. The study was guided by the vision of the WHO Council on the Economics of Health for All to build an economy for health using its four work streams of value, finance, innovation and capacity. Based on the findings of the study, we offer a mission-oriented policy framework to support the mRNA technology transfer programme as a pilot for transformative change towards an ecosystem for health innovation for the common good. Parts of this vision have already been incorporated into the governance of the mRNA technology transfer programme, while other aspects, especially the common good approach, still need to be applied to achieve the goals of the programme., ((c) 2024 The authors; licensee World Health Organization.)

In South Africa, approximately 98% of the predicted total surface water resources are already being used up. Consequently, the National Water Resource Strategy considers groundwater to be important for the future planning and management of water resources. In this case, quantifying groundwater budgets is a prerequisite because they provide a means for evaluating the availability and sustainability of a water supply. This study estimated the regional groundwater budgets for the Inkomati-Usuthu Water Management Area (Usuthu, Komati, Sabie-Sand, and Crocodile) using the classical hydrological continuity equation. The equation was used to describe prevailing feedback loops between groundwater draft, recharge, baseflow, and storage change. The results were coarser scale estimates which, beforehand, were derived from the 2006 study. In the years to follow, groundwater reliance intensified and there was also the historic 2015/2016 drought. This inevitably led to an increased draft while the rest of the components of the groundwater budgets experienced decreases. Both Crocodile and Sabie-Sand experienced groundwater storage depletion which led to reduced baseflow and groundwater availability, while groundwater recharge contrarily increased due to capture. Conversely, the other two catchments experienced relatively lower drafts with correspondingly higher groundwater availability and recharge while storage change was positive. The results highlighted the need for adaptive water management whose effectiveness relies on predictive studies. Consequently, future models should be developed to capture the spatial and temporal dynamism of the natural groundwater budget due to climate change, water demands, and population growth predictions., (© 2024 National Ground Water Association.)

Background: Kidney transplantation remains the treatment of choice for children with kidney failure (KF). In South Africa, kidney replacement therapy (KRT) is restricted to children eligible for transplantation. This study reports on the implementation of the Paediatric Feasibility Assessment for Transplantation (pFAT) tool, a psychosocial risk score developed in South Africa to support transparent transplant eligibility assessment in a low-resource setting., Methods: Single-center retrospective descriptive analysis of children assessed for KRT using pFAT tool from 2015 to 2021., Results: Using the pFAT form, 88 children (median [range] age 12.0 [1.1 to 19.0] years) were assessed for KRT. Thirty (34.1%) children were not listed for KRT, scoring poorly in all domains, and were referred for supportive palliative care. Fourteen of these 30 children (46.7%) died, with a median survival of 6 months without dialysis. Nine children were reassessed and two were subsequently listed. Residing >300 km from the hospital (p = .009) and having adherence concerns (p = .003) were independently associated with nonlisting. Of the 58 (65.9%) children listed for KRT, 40 (69.0%) were transplanted. One-year patient and graft survival were 97.2% and 88.6%, respectively. Only one of the four grafts lost at 1-year posttransplant was attributed to psychosocial issues., Conclusions: Short-term outcomes among children listed using the pFAT form are good. Among those nonlisted, the pFAT highlights specific psychosocial/socioeconomic barriers, over which most children themselves have no power to change, which should be systemically addressed to permit eligibility of more children and save lives., (© 2024 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC.)

Democratic governments sometimes use violence against their people, yet little is known about the electoral consequences of these events. Studying South Africa's Marikana massacre, we document how a new opposition party formed as a direct result of violence, quantify significant electoral losses for the incumbent, and show that those losses were driven by voters switching from the incumbent to the new party. Three lessons emerge. First, incumbents who preside over state violence may be held electorally accountable by voters. Second, such accountability seemingly depends on the existence of credible opposition parties that can serve as a vector for disaffected voters. Where such parties do not exist, violence may create political cleavages that facilitate the formalization of opposition movements. Third, immediate proximity to violence is correlated with holding incumbents accountable. [ABSTRACT FROM AUTHOR]

Under what conditions do states protect minority rights in a context of domestic resistance? Recent decades have seen rapid divergence on LGBT rights worldwide, with Africa presented as "norms antipreneur" in the face of international pressure. Yet, in 1996, South Africa was the first country in the world to provide constitutional protection on grounds of sexual orientation. This article develops an original theory on LGBT rights protection using a conflict-to-rights framework. Employing process tracing, elite interviews and archival sources, I show how a situation of insurgency allows LGBT activists to build networks and increase egalitarian attitudes to attain in-group status. Continued violence also works to block public participation in policy-making while dividing opposition forces, allowing a tiny group of activists to effectively lobby for change. [ABSTRACT FROM AUTHOR]

Purpose: Joint ventures (JVs) serve as a viable tool in mitigating some of the challenges posed to the effective delivery of construction projects. However, JVs are highly susceptible to failure in most developing countries. Therefore, this study seeks to unravel the critical factors influencing the failure of JVs in the South African construction industry. Design/methodology/approach: A quantitative approach was adopted for the study using a well-structured questionnaire as the instrument for data collection. Respondents for the study were built environment professionals in Gauteng province in South Africa. Data elicited from respondents were analyzed using a four-pronged process which included descriptive statistics, one sample t-test, exploratory factor analysis and confirmatory factor analysis. Findings: Resulting from the analysis conducted, four critical components emerged as the major factors influencing the failure of JVs in the South African construction industry, which are inefficient financial framework, divergent organizational culture, poor project governance and inadequacies from project stakeholders. Practical implications: The outcome of this study presents a roadmap for stakeholders in the construction industry with the requisite knowledge of the critical factors leading to the failure of JVs, consequently providing a clear path for the successful delivery of JV mandates. Originality/value: Evidence from literature suggests that several studies have been conducted on the various aspects of JVs in the South African construction industry; however, none has focused on the leading factors attributed to the failure of JVs. Also, the findings of this study cultivate a good theoretical platform for future studies on JVs. [ABSTRACT FROM AUTHOR]

Water renewal and flushing in small, intermittently open or closed estuaries is receiving increasing attention particularly in light of the climate change induced alterations in run-off, wave and sediment transport conditions along coasts. The challenges of predicting the stratification-circulation state and the balance between tidal or freshwater flushing in response to the mouth dynamics of small, wave-dominated estuaries is the focus of the paper. Such predictions are required for determining estuary freshwater requirements or establishing an estuary's capacity to maintain sound water quality under pollutant discharges. Advances in simulating changes in stratification-circulation over long time scales are limited. Instead attention has focused on generating indices of stratification or water quality state using heuristic methods. In this paper, systems dynamics modelling is applied to simulate the non-linear response of the estuary to changes in river and marine water fluxes. The estuary is modelled as a basin with a specified water volume to water level relationship, connected to the sea by a channel with variable sill height, but fixed width. The direction and magnitude of the flow through the mouth determines whether the sill height erodes or accretes and hence the mouth dynamics (see Slinger, 2017). The tidal flux through the mouth co-determines the volumetric exchange of salt, influencing both the stratification state of the estuary and the degree of tidal or freshwater flushing. This is also influenced by run-off. The resulting dynamic balance is captured in two bulk indices, the Estuarine Richardson number and the bulk densimetric Froude number. Using measured data from the Great Brak Estuary, South Africa, the model is calibrated. Model simulations demonstrate the importance of tidal flushing and concomitant mouth breaching for water renewal as freshwater flushing declines under scenarios of increased water abstraction. Although the estuary remains partially mixed, there is increased average salinity and a more uniform the water column. Water releases and mouth breaching bring about a more natural stratification-circulation state, but these effects are short-lived. • Parametric simulation of water renewal in wave-dominated, intermittent estuaries. • A stratification index analogous to the Estuarine Richardson number is modelled. • A circulation index analogous to the bulk densimetric Froude number is simulated. • Stratification-circulation simulations indicate increased water column uniformity. • Mouth breaching & floods temporarily allow more natural stratification-circulation. [ABSTRACT FROM AUTHOR]

Despite a sound policy framework, the right of learners with disabilities in South Africa to inclusive and equitable quality education is not being met. A key reason hindering the realisation of this right is that there are very few teacher education programs focused on supporting learners with disabilities. Acknowledging the urgency of teacher education, in this paper we draw on qualitative data from 109 teacher participants and 39 course facilitators of a series of disability inclusion-focused teacher education short courses in the Western Cape province of South Africa. Based on their experience of the courses, we consider how teachers can be empowered to meet the diverse needs of their learners within an inclusive framework. Findings highlight that professional and personal growth facilitated a more empathic understanding of learners and the opportunity to collaborate with others, enabling teachers to find creative ways of solving problems faced in their workplaces. To support teachers in meeting the needs of their learners, teacher training should facilitate active reflection on the role they play in shaping the lives of their learners, and prepare teachers to respond to challenges strategically, taking advantage of the resources available to them within and beyond their school environment. [ABSTRACT FROM AUTHOR]

Purpose: This research aimed to assess the leadership role of principals in the implementation of peace education in selected secondary schools in the Western Cape, South Africa. Design/methodology/approach: This study employed qualitative research approach to assess the leadership role of principals in the implementation of peace education in selected secondary schools in the Western Cape, South Africa. Data were gathered from a small sample of six principals from six selected secondary schools which were engaged in the implementation of a peace education programme, and data were analysed using thematic content analyses. Findings: Findings of the study suggest that principals possess a low level of understanding or awareness of their leadership role in the implementation of peace education. The study pointed out the constraints such as time constraints and learners' negative attitudes and social influences hinder the effective implementation of peace education in selected secondary schools. Research limitations/implications: First, the data were self-reported and therefore subject to social desirability bias; participants may have provided socially desirable responses rather than their true belief or experiences. Thus, participants may have overstated their role in and commitment to the peace education programme. Originality/value: Studies that aim to explore alternative approaches to combat violence, such as peace education, are still limited in South Africa. Hence, this paper served to close that gap by contributing to the growing body of research on the leadership role of the principal in the implementation of peace education in the school and exploring barriers hampering its effective implementation. [ABSTRACT FROM AUTHOR]

This paper critically explores the use of satire and humour by fast-foods outlets in South Africa and Zimbabwe to advertise and market their menu through digital media platforms, Facebook and Twitter. Using Nando's South Africa and Mambo's Chicken, in Zimbabwe, as case studies, we examine how satire and humour are used as advertising strategies, and as a reflection of these countries' economic and political environments. Consumers are overwhelmed with information coming from different sources such as Television, radio, newspapers and Internet. The paper's theoretical approach is gleaned from advertising and satire. We argue that through their encounter with food, consumers tend to understand the reason behind their 'empty stomach', and mediate on prevailing socio-political and economic issues. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to identify and discuss impediments in the compilation of an application for a search and seizure warrant for digital evidence and the structure of such a warrant in South African criminal cases. Design/methodology/approach: This paper provides a brief overview of international and local impediments, followed by a detailed discussion of the implications of these impediments and how it is approached in various jurisdictions. The methodology of this paper consists of a literature review. Findings: Addressing the impediments in the compilation of the application and the warrant will be beneficial for forensic investigators, the South African Police Service (SAPS) and the administration of justice in South Africa. Research limitations/implications: Search and seizures for digital evidence form part of civil, regulatory and criminal search and seizures. This study focuses on the search and seizure of digital evidence in criminal matters pursuant to mainly the provisions of the Criminal Procedure Act 51 of 1977 and the Cybercrimes Act 19 of 2020. Originality/value: The originality of this paper lies in the approach to the drafting of applications for search and seizure warrants for digital information in South Africa. The contribution of the study is that, by using this approach, the SAPS can address the impediments during the application and compilation of the warrants, which would enhance the quality of investigations and contribute to the successful investigation and prosecution of crime in South Africa. [ABSTRACT FROM AUTHOR]

Dense medium separation circuits use a dense medium to separate low density waste material from high density valuable minerals. Since the dense medium is an expensive consumable, it is recovered after separation of the valuable minerals from waste. A dynamic nonlinear model of a dense medium separation circuit of an iron ore plant in South Africa is developed to track the flow of medium in the circuit. An extended Kalman filter is designed for estimating observable but unmeasured states. The model is validated using online plant data. This paper serves as a precursor for further work to detect and mitigate expensive medium losses in the circuit. • A dense medium separation circuit is modelled from first principles. • Each unit process model is evaluated for state observability. • The states are estimated from industrial data using an extended Kalman filter. • The results indicate how the estimates can be used to detect medium losses. [ABSTRACT FROM AUTHOR]

This paper examines the impact of district‐level crime rates in South Africa on individual depression symptoms. We use panel data from the National Income Dynamics Survey collected between 2008 and 2014 and estimate an individual fixed effects regression model, thus controlling for characteristics of the individual's environment that could affect crime and mental health. We find that an increase of one standard deviation in property (violent) crime is associated with a 7.2 (8.7) percentage point increase in the probability of depression symptoms. Analysis of potential mechanisms suggests that indirect exposure to crime likely affects mental health by increasing stress rather than by changing physical health or labor market outcomes. [ABSTRACT FROM AUTHOR]

As the scholarship on youth grows, so does the focus on the predicaments youth face increases. In particular, the phenomenon of waithood, which refers to a prolonged period of transition from youth to adulthood, has been attracting much attention from researchers. This article builds upon this growing literature by examining the roles that soccer academies in Ghana and shelters for unaccompanied young migrants in South Africa play in creating, sustaining, and spreading the waithood of youth. Even though both institutions operate in different spaces and promote distinct activities, they share a mutual goal by presenting themselves as educational stepping stones for a better present and future for African youths. Nevertheless, given the gaps between what both institutions claimed to provide and what they provided in reality, we argue that they served as the root of waithood for their young residents. As the following ethnography reveals, with worsening basic living conditions, infrequent access to school, and unattainable dreams about universities and European soccer leagues, many youths in shelters and academies were left incapable of assuming adult responsibilities and enjoying adult privileges. Our findings suggest that, unlike common perception of waithood as a phenomenon that takes place after school and before formal employment, waithood is also an institution-based phenomenon that can be facilitated within the education system. Simultaneously, in contrast to the common scholarly portrayals of waithood as an individual experience, we argue that waithood is a communal social phenomenon. At South African shelters and Ghanaian academies, the period of suspension and the prolonged journey to adulthood trickled-down to wider social and familial circles. The youth's efforts to seek alternative paths for adulthood, as well as the support they get from relatives and friends, reduces the loneliness of their waithood, though their contributions are hampered by local economic and political challenges. [ABSTRACT FROM AUTHOR]

Ethnopharmacological Relevance: The analyses of patterns of over-representation of southern African traditional medicinal plants at the genus and family level provide information about the differences in plant use among southern African countries and disease categories. 'Over-representation' refers to the phenomenon whereby the proportion of plants belonging to a taxonomic group is higher in ethnobotanical pharmacopoeia than in the total flora., Aim of the Study: This study aimed to use the Imprecise Dirichlet Model (IDM) to analyse data from ten southern African countries to establish how over-represented medicinal plant families compare with over-represented genera, how over-represented medicinal taxa differ among countries in this region of Africa, and how over-represented taxa differ among six major disease categories., Materials and Methods: Floral data for the total species composition of each country were obtained from online databases. Medicinal plant species lists were generated from published surveys, inventories, and books. IDM calculations were executed using the inverse of the cumulative beta probability density function in Microsoft Excel™. Python programming language source code was used to calculate Pearson correlation (r) values and Jaccard coefficients (J)., Results: Nine of forty-two over-represented medicinal plant families in southern Africa (group 1) do not have over-represented genera. Seven of the forty genera with the highest margins of over-representation belong to under-represented families. Nineteen of the forty-two over-represented families have margins of over-representation smaller than the cumulative margins of their over-represented genera. Groups of countries with similar overall flora (J ≥ 0.333) are Botswana and Namibia (group 2), Malawi, Mozambique, Zambia and Zimbabwe (group 3). The families and genera with the highest margins of over-representation are Loganiaceae and Albizia in group 1, Combretaceae and Vachellia in group 2, Dioscoreaceae and Senna in group 3, and Sapotaceae and Solanum in group 4 (South Africa). The families and genera with the highest margins of over-representation across disease categories are Ebenaceae and Albizia, Canellaceae and Dicoma, Combretaceae and Pterocelastrus, Ebenaceae and Bersama, Francoaceae and Erythrina, and Aristolochiaceae and Strychnos for plants used in the treatment of STIs, febrile and mosquito-vector diseases, microbial infections, pain, skin conditions, and female sexual/reproductive problems, respectively., Conclusions: Genus-level calculations are more efficient in generating taxonomic lists that can be used for ethnopharmacological investigations due to the exclusion of under-represented genera. Limiting the size of geographical areas from which medicinal plant lists are sampled and targeting plants used to treat specific types of disease prevents the underestimation of niche over-represented taxa., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Ethnopharmacological Relevance: Blood purification practices, also referred to as blood cleansing or detoxification, is an ancient concept which is widespread within African traditional medicine. There is, however, limited consolidated information about the selection of plant species, the purpose of use and how the preparation is made. An in-depth examination of how regional communities use medicinal plants for blood purification is needed to better understand this ethnopharmacological practice., Aim of the Study: To gather knowledge on the traditional use of medicinal plants used for the purpose of blood purification by laypersons in northern Maputaland, KwaZulu-Natal, South Africa., Methods: An ethnobotanical survey was conducted on medicinal plants used in the rural areas of northern Maputaland for blood purification. Interviews were conducted in 55 homesteads, where the most knowledgeable participant per household was interviewed using structured questionnaires. Information collected included knowledge of the concept of blood purification, purpose for medicating, plant selection, and mode of preparation. The most important species and families were identified through indices., Results: Sixty-four plant species from 35 families were recorded as blood purifiers for the treatment of ailments linked to the need for blood purification. Terminalia sericea Burch. ex DC. was the most used plant species (mentioned by 39% of the people interviewed). The conditions that were mostly associated with blood purification were skin complaints, gastro-intestinal disorders, and overall improvement of general health. Blood purification is also commonly used for non-medical purposes such as granting good luck or as a love charm. Six new plant species and five new Zulu vernacular names had not previously been documented for blood purification., Conclusion: The frequently mentioned use of medicinal plants for blood purification by the rural community of northern Maputaland clearly emphasises the importance of this cultural practice. There is no doubt that when examining African traditional medicine, holistic terms such as "blood cleansing" cannot be ignored. Future studies may provide a better understanding of this often misunderstood and undocumented practice., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: This paper investigates the perceptions of medical interns regarding the usefulness of non-mother tongue communication skills taught during the undergraduate curriculum at the University of Cape Town in South Africa. In 2003, the university decided to incorporate Afrikaans and IsiXhosa communication skills into the new MBChB curriculum in order to meet the Faculty of Health Sciences goals to promote quality and equity in healthcare, and to prepare graduating health practitioners for multilingual communities where they would be serving. Despite annual internal evaluations and reviews of the languages courses, the usefulness, if any, of the additional languages in the working clinical environment had not been determined., Methods: Data were collected during the second year of medical internship across a five-year period through survey questionnaires, as well as focus group interviews conducted in the Western Cape, South Africa. Surveys were conducted from 2009 to 2013., Results: The study shows that the usefulness of each of the probed categories was not consistent across both languages. The interns expressed a need for an overall improvement of the isiXhosa course offering, while the outcomes for the Afrikaans language were more positive across all categories except for cultural understanding., Conclusion: The study indicates a positive trend amongst the interns towards developing usefulness in communication skills in Afrikaans and isiXhosa to communicate with their patients., (© 2024. The Author(s).)

Introduction: Pre-exposure prophylaxis (PrEP) is an HIV prevention strategy that can reduce the risk of HIV acquisition by more than 90% if taken consistently. Although South Africa has been implementing PrEP since 2016, initially for selected population groups before expanding access to more people, there is a dearth of research focused on PrEP among adolescent boys and young men (ABYM), despite them experiencing high rates of HIV infection. To address this gap, we compared PrEP initiation rates by service delivery points (SDPs) among ABYM in KwaZulu-Natal, South Africa. Methods: We conducted a population-based prospective study in 22 SDPs from July 2021 to July 2022 in KwaZulu-Natal, South Africa. Sexually active ABYM aged 15–35 years who tested HIV negative were recruited at purposively selected PrEP SDPs (i.e., healthcare facilities, secondary schools and Technical Vocational Education and Training (TVET) colleges, and community-based youth zones). We collected baseline quantitative data from each participant using self-administered electronic questionnaires built into REDCap, including demographic information such as age, sex, employment status and level of education, as well as PrEP initiation outcomes. We extracted data from REDCap and exported it to Stata version 17.0 for analysis, and then eliminated discrepancies and removed duplicates. We described baseline characteristics using summary and descriptive statistics (median, interquartile range [IQR] and proportions) and reported PrEP initiation proportions overall and by SDPs. Results: The study included 1104 ABYM, with a median age of 24 years (interquartile range (IQR): 21–28)). Almost all participants were black African (n = 1090, 99%), with more than half aged 15–24 years (n = 603, 55%) and 45% (n = 501) aged 25–35 years. The majority (n = 963; 87%) had attained a secondary level of education. Overall PREP initiation rate among adolescent boys and young men was low: among 1078 participants who were eligible for PrEP, 13% (n = 141) were started on PrEP. Among the participants who were initiated on PrEP, over three quarters (78%, n = 58) were initiated from high schools, compared with community-based youth zones (40%, n = 37), TVET colleges (26%, n = 16) and healthcare facilities (4%, n = 30). Conclusions: This study provided evidence suggesting that expanding PrEP services to non-traditional settings, such as high schools, TVET colleges, and community-based organizations, may have a potential to increase PrEP access among ABYM in South Africa. [ABSTRACT FROM AUTHOR]

Background: Globally, families experience challenges caring for and raising children with intellectual disability (ID). Family caregivers in rural states are mostly known for lacking support resources, including information on understanding the care of ID. Lack of adequate information on understanding of ID compromises the provision of life-long care and support of the children with ID's physical, emotional, psychological and social developmental well-being. The study aimed to explore the information needs of family caregivers regarding the care of children with ID in rural areas of Limpopo Province, South Africa. Methods: This qualitative explorative research conducted 16 in-depth individual interviews and one focus group discussion with ten family members. The participants shared their experiences of raising children with ID in rural communities. Inductive thematic analysis using Atlas Ti software categorised emerging themes and subthemes of this study from merged data sets on information needs regarding the care of children with ID among family caregivers. Results: The findings highlighted the need for information regarding ID care among family caregivers raising children with ID in the home environment. The information challenges experienced by family caregivers include caring for the challenging behaviour of children with ID and available support resources and services for the children and their families. These challenges impact the care and support required to meet the developmental needs of children with ID. Furthermore, inadequate information on ID among family caregivers in rural communities with a lack of resources restricts the children from accessing required support services. Conclusions: Given the information challenges these families face on ID, the stakeholders must develop continuous training programmes that will equip, empower, and further monitor ID care and management among family caregivers to enhance care and the raising of children with dignity. [ABSTRACT FROM AUTHOR]

AI-based simulations for educational and assessment purposes are gaining global recognition. Informed by cultural comparison research, this study investigates cross-country variations in users' utilization and perceptions of a simulation-based assessment. Specifically, we conducted a comparative analysis between a sample of South African and Canadian students to uncover potential differences in assessment scores, communication patterns, and reactions vis-a-vis a simulation assessment for evaluating teamwork skills. Data were collected from over 500 undergraduate students in South Africa and Canada who completed a simulation assessment and reported their reactions and perceptions. The findings yielded several noteworthy observations. First, South African students attained higher assessment scores than Canadian students; although, the difference did not quite reach statistical significance at p < 0.05. Second, significant variations were observed in the quantity and style of communication. South African students used fewer words and more polite language, while Canadian students tended to use more decisive language and provided more explanations and help to their virtual teammates. Third, South African students were more likely to perceive their virtual teammates as "human" and were less concerned whether they were real people or virtual. Lastly, compared with their Canadian counterparts, South African students reported more positive reactions and perceived the assessment to be more accurate. These findings warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare in South Africa aims to transform the national health system by emphasising community-based care and preventive strategies. However, rehabilitation services, particularly for individuals with disabilities and chronic non-communicable diseases, are often overlooked in primary healthcare. This study aimed to investigate the provision of primary healthcare rehabilitation services in the Johannesburg Metropolitan District by exploring client sociodemographics and variations in services provided by rehabilitation professionals. Methods: A retrospective review of clinic rehabilitation records from 2011 to 2020 was conducted at nine provincially funded community health centres (CHCs) offering rehabilitation services. Stratified sampling facilitated record selection based on rehabilitation service type and year. A specifically designed data extraction tool captured demographics, disabilities, rehabilitation received, and referral sources. Descriptive analysis used means, standard deviations, and frequencies. Results: The findings show a diverse client population with a wide age range, with a significant proportion falling into the < 5 years and 30–49 years age groups. Neuromusculoskeletal and movement-related disabilities were most prevalent, affecting approximately two-thirds of clients. Referral sources were often undocumented, and inconsistent discharge information with no record of patient follow up, highlighted the need for improved documentation practices. Clinic visits were the primary service delivery mode, followed by limited home visits and outreach services. Occupational therapy and physiotherapy were the most used services. Speech and language therapy services were underused, and some CHCs lacked audiology services. There were variations in the number of individual and group sessions provided by the different rehabilitation services, and there were age- and disability-specific differences in service use. Conclusion: This study offers insights into rehabilitation service provision in the Johannesburg Metropolitan District and enhances our understanding of rehabilitation services in primary healthcare settings. It underscores the importance of a multidisciplinary rehabilitation team to address diverse rehabilitation needs, improving documentation and discharge practices, expanding service delivery models, and reducing disparities in service use. The findings inform strategies for optimising service delivery, workforce, resource allocation, and intersectoral collaboration to ultimately enhance the quality and accessibility of integrated rehabilitation services. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer remains a leading cause of death, particularly in developing countries. WHO screening guidelines recommend human papilloma virus (HPV) detection as a means to identify women at risk of developing cervical cancer. While HPV testing identifies those at risk, it does not specifically distinguish individuals with neoplasia. We investigated whether a quantitative molecular test that measures methylated DNA markers could identify high-risk lesions in the cervix with accuracy. Results: Marker discovery was performed in TCGA-CESC Infinium Methylation 450 K Array database and verified in three other public datasets. The panel was technically validated using Quantitative Multiplex-Methylation-Specific PCR in tissue sections (N = 252) and cervical smears (N = 244) from the USA, South Africa, and Vietnam. The gene panel consisted of FMN2, EDNRB, ZNF671, TBXT, and MOS. Cervical tissue samples from all three countries showed highly significant differential methylation in squamous cell carcinoma (SCC) with a sensitivity of 100% [95% CI 74.12–100.00], and specificity of 91% [95% CI 62.26–99.53] to 96% [95% CI 79.01–99.78], and receiver operating characteristic area under the curve (ROC AUC) = 1.000 [95% CI 1.00–1.00] compared to benign cervical tissue, and cervical intraepithelial neoplasia 2/3 with sensitivity of 55% [95% CI 37.77–70.84] to 89% [95% CI 67.20–98.03], specificity of 93% [95% CI 84.07–97.38] to 96% [95% CI 79.01–99.78], and a ROC AUC ranging from 0.793 [95% CI 0.68–0.89] to 0.99 [95% CI 0.97–1.00] compared to CIN1. In cervical smears, the marker panel detected SCC with a sensitivity of 87% [95% CI 77.45–92.69], specificity 95% [95% CI 88.64–98.18], and ROC AUC = 0.925 [95% CI 0.878–0.974] compared to normal, and high-grade squamous intraepithelial lesion (HSIL) at a sensitivity of 70% (95% CI 58.11–80.44), specificity of 94% (95% CI 88.30–97.40), and ROC AUC = 0.884 (95% CI 0.822–0.945) compared to low-grade intraepithelial lesion (LSIL)/normal in an analysis of pooled data from the three countries. Similar to HPV-positive, HPV-negative cervical carcinomas were frequently hypermethylated for these markers. Conclusions: This 5-marker panel detected SCC and HSIL in cervical smears with a high level of sensitivity and specificity. Molecular tests with the ability to rapidly detect high-risk HSIL will lead to timely treatment for those in need and prevent unnecessary procedures in women with low-risk lesions throughout the world. Validation of these markers in prospectively collected cervical smear cells followed by the development of a hypermethylated marker-based cervical cancer detection test is warranted. [ABSTRACT FROM AUTHOR]

The African continent is confronted with interconnected challenges of water, energy, and food insecurity, particularly affecting marginalized urban residents. Decentralized Water-Energy-Food (WEF) systems have emerged as potential solutions to alleviate these issues exacerbated by climate change. Despite scholarly acknowledgment of constraints related to WEF, there is a growing global trend towards trials of innovative decentralized WEF systems. This paper contributes to the body of research aimed at demonstrating the applicability of decentralised WEF systems at local level, by showcasing the potential of such systems to enhance water, energy and food security in informal settlements. Focusing on Diepsloot slums in Johannesburg, South Africa, the paper applied space analysis, least-cost modeling of sack farming, and renewable energy technologies in providing WEF solutions that demonstrate feasibility, sustainability and decentralised solutions for informal settlements, compared to the popular broad-based solutions that often neglect these marginalised communities. Utilizing Geographic Information Systems (GIS), AquaCrop crop modeling, financial analysis, and linear optimization modelling urbs, the study provides a comprehensive analysis of past climate trends, water sources, spatial plant arrangements, and a proposed community centre. The proposed Phezulu 'Up' growers' model and the positive return on investment further demonstrate the feasibility of decentralized WEF systems. Policymakers are encouraged to promote these WEF systems to bolster urban livelihoods and achieve Sustainable Development Goals (SDGs), notably SDG 2, 6, and 7, in marginalized African urban areas. Recommendations and areas of further research include looking into issues of community engagement, partnerships, risk mitigation, strategies for equity and inclusivity and local knowledge integration during WEF implementation, and robust critique of WEF practical interventions and comparative analysis with other WEF models. Overall, the study provides a blueprint for inclusive and sustainable urban development, emphasizing the importance of localized WEF solutions and community empowerment. [ABSTRACT FROM AUTHOR]

Transition from traditional high-fiber to Western diets in urbanizing communities of Sub-Saharan Africa is associated with increased risk of non-communicable diseases (NCD), exemplified by colorectal cancer (CRC) risk. To investigate how urbanization gives rise to microbial patterns that may be amenable by dietary intervention, we analyzed diet intake, fecal 16 S bacteriome, virome, and metabolome in a cross-sectional study in healthy rural and urban Xhosa people (South Africa). Urban Xhosa individuals had higher intakes of energy (urban: 3,578 ± 455; rural: 2,185 ± 179 kcal/d), fat and animal protein. This was associated with lower fecal bacteriome diversity and a shift from genera favoring degradation of complex carbohydrates (e.g., Prevotella) to taxa previously shown to be associated with bile acid metabolism and CRC. Urban Xhosa individuals had higher fecal levels of deoxycholic acid, shown to be associated with higher CRC risk, but similar short-chain fatty acid concentrations compared with rural individuals. Fecal virome composition was associated with distinct gut bacterial communities across urbanization, characterized by different dominant host bacteria (urban: Bacteriodota; rural: unassigned taxa) and variable correlation with fecal metabolites and dietary nutrients. Food and skin microbiota samples showed compositional differences along the urbanization gradient. Rural-urban dietary transition in South Africa is linked to major changes in the gut microbiome and metabolome. Further studies are needed to prove cause and identify whether restoration of specific components of the traditional diet will arrest the accelerating rise in NCDs in Sub-Saharan Africa. Here, the authors present a comparative analysis of the diet, microbiome and metabolome of rural and urban Xhosa people in South Africa, associating urban diets with higher abundances of pro-neoplastic microbial metabolites. [ABSTRACT FROM AUTHOR]

Background: The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022., Methods: The GFBR is an annual meeting organized by the World Health Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was "Ethics of AI in Global Health Research". The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022., Results: We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships., Conclusions: The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research., (© 2024. The Author(s).)

Fieldwork challenges involving hard-to-reach populations and with which many novice researchers grapple are apparent. However, literature on the issues related to female researchers' experiences with hard-to-reach populations like undocumented foreign migrants is scarce. This article reflects on local female researchers' fieldwork experiences during a study on the socio-economic impacts of the COVID-19 pandemic on foreign migrants operating informal businesses in the downtown area of Bloemfontein, South Africa. Our findings highlight unique challenges confronted by local female researchers compared to their male counterparts, including the risk of physical and emotional harm. Despite these challenges, female researchers play a vital role in accessing and understanding hard-to-reach populations, contributing immensely to the fieldwork research process. We also recognize the influence of contextual factors, such as xenophobia, on fieldwork dynamics, emphasizing the need to consider broader socio-political factors during fieldwork. To foster more inclusive research practices, we advocate for the involvement of members from hard-to-reach populations as integral members of the research team, offering their invaluable insider perspectives, knowledge and cultural milieu. Looking ahead, we call for greater support for women in research, including gender-sensitive training, and increased awareness of gender-based risks during fieldwork. [ABSTRACT FROM AUTHOR]

Biomedical research using human biological material and data is essential for improving human health, but it requires the active participation of many human volunteers in addition to the distribution of data. As a result, it has raised numerous vexing questions related to trust, privacy and consent. Trust is essential in biomedical research as it relates directly to the willingness of participants to continue participating in research. Privacy and the protection of personal information also influence trust. Informed consent has proven to be insufficient as it cannot overcome the informational deficit between primary and unknown future uses of material and data and is therefore not fully informed and invalid. Broad consent is also problematic as it takes full control of samples and data flow from the research participant and inherently requires that a participant must trust that the researcher will use their material or data in a manner that they would find acceptable. This paper attempts to offer some insight into how these related issues can be overcome. It introduces dynamic consent as a consent model in research involving human biological material and its associated data. Dynamic consent is explained, as well as its claims of superiority in instances where future research is possible. It is also shown how dynamic consent contributes to better control of the samples and data by the research participant, and how trust may be improved by using this consent model. Dynamic consent's co-existence with and support of the South African Protection of Personal Information Act of 2013 is also assessed. The limitations of dynamic consent are also discussed. [ABSTRACT FROM AUTHOR]

Background: Sub-Saharan Africa is the region with the highest under-five mortality rate globally. Child healthcare decisions should be based on rigorously developed evidence-informed guidelines. The Global Evidence, Local Adaptation (GELA) project is enhancing capacity to use global research to develop locally relevant guidelines for newborn and child health in South Africa (SA), Malawi, and Nigeria. The first step in this process was to identify national priorities for newborn and child health guideline development, and this paper describes our approach., Methods: We followed a good practice method for priority setting, including stakeholder engagement, online priority setting surveys and consensus meetings, conducted separately in South Africa, Malawi and Nigeria. We established national Steering Groups (SG), comprising 10-13 members representing government, academia, and other stakeholders, identified through existing contacts and references, who helped prioritise initial topics identified by research teams and oversaw the process. Various stakeholders were consulted via online surveys to rate the importance of topics, with results informing consensus meetings with SGs where final priority topics were agreed., Results: Based on survey results, nine, 10 and 11 topics were identified in SA, Malawi, and Nigeria respectively, which informed consensus meetings. Through voting and discussion within meetings, and further engagement after the meetings, the top three priority topics were identified in each country. In SA, the topics concerned anemia prevention in infants and young children and post-discharge support for caregivers of preterm and LBW babies. In Malawi, they focused on enteral nutrition in critically ill children, diagnosis of childhood cancers in the community, and caring for neonates. In Nigeria, the topics focused on identifying pre-eclampsia in the community, hand hygiene compliance to prevent infections, and enteral nutrition for LBW and preterm infants., Conclusions: Through dynamic and iterative stakeholder engagement, we identified three priority topics for guideline development on newborn and child health in SA, Malawi and Nigeria. Topics were specific to contexts, with no overlap, which highlights the importance of contextualised priority setting as well as of the relationships with key decisionmakers who help define the priorities., (© 2024. The Author(s).)

Background: The use of systems engineering tools, including the development and use of care cascades using routinely collected data, process mapping, and continuous quality improvement, is used for frontline healthcare workers to devise systems level change. South Africa experiences high rates of tuberculosis (TB) infection and disease as well as HIV co-infection. The Department of Health has made significant gains in HIV services over the last two decades, reaching their set "90–90-90" targets for HIV. However, TB services, although robust, have lagged in comparison for both disease and infection. The Systems Analysis and Improvement Approach (SAIA) is a five-step implementation science method, drawn from systems engineering, to identify, define, and implement workflow modifications using cascade analysis, process mapping, and repeated quality improvement cycles within healthcare facilities. Methods: This stepped-wedge cluster randomized trial will evaluate the effectiveness of SAIA on TB (SAIA-TB) cascade optimization for patients with TB and high-risk contacts across 16 clinics in four local municipalities in the Sarah Baartman district, Eastern Cape, South Africa. We hypothesize that SAIA-TB implementation will lead to a 20% increase in each of: TB screening, TB preventive treatment initiation, and TB disease treatment initiation during the 18-month intervention period. Focus group discussions and key informant interviews with clinic staff will also be conducted to determine drivers of implementation variability across clinics. Discussion: This study has the potential to improve TB screening, treatment initiation, and completion for both active disease and preventive measures among individuals with and without HIV in a high burden setting. SAIA-TB provides frontline health care workers with a systems-level view of their care delivery system with the aim of sustainable systems-level improvements. Trial registration: Clinicaltrials.gov, NCT06314386. Registered 18 March 2024, https://clinicaltrials.gov/study/NCT06314386. NCT06314386. [ABSTRACT FROM AUTHOR]

Background: The global campaign for "Undetectable equals Untransmittable" (U = U) seeks to spread awareness of HIV treatment as prevention, aiming to enhance psychological well-being and diminish stigma. Despite its potential benefits, U = U faces challenges in Sub-Saharan Africa, with low awareness and hesitancy to endorse it. We sought to develop a U = U communications intervention to support HIV counselling in primary healthcare settings in South Africa. Methods: We used Intervention Mapping (IM), a theory-based framework to develop the "Undetectable and You" intervention for the South African context. The six steps of the IM protocol were systematically applied to develop the intervention including a needs assessment consisting of a systematic review and qualitative research including focus group discussions (FGD) and key informant (KI) interviews. Program objectives and target population were determined before designing the intervention components and implementation plan. Results: The needs assessment indicated low global U = U awareness, especially in Africa, and scepticism about its effectiveness. Lay counsellors and clinic managers stressed the need for a simple and standardized presentation of U = U addressing both patients' needs for encouragement and modelling of U = U success but also clear guidance toward ART adherence behaviour. Findings from each step of the process informed successive steps. Our final intervention consisted of personal testimonials of PLHIV role models and their partners, organized as an App to deliver U = U information to patients in primary healthcare settings. Conclusions: We outline an intervention development strategy, currently in evaluation stage, utilizing IM with formative research and input from key U = U stakeholders and people living with HIV (PLHIV). [ABSTRACT FROM AUTHOR]

This paper explores the Holocene climatic dynamics of South Africa's southern Cape, a region that supports a large proportion of the Greater Cape Floristic Region and contains an array of important archaeological sites. While South African climates are generally characterised by marked rainfall seasonality, the southern Cape is currently situated at the interface between tropical and temperate climate systems, resulting in a largely aseasonal rainfall regime. This regime, however, is thought to have been particularly sensitive to past changes in late Quaternary boundary conditions, meaning that variability in either tropical or temperate systems could have significant environmental impacts. Evidence of past climate change, however, remains limited. We present a 9000-year record of hydroclimatic variability obtained from rock hyrax midden stable nitrogen records, from Papkuilsfontein, on the southern slope of the Anysberg Mountains. Resolved to an average 6-year resolution and spanning the period c. 9050 cal yr BP to 1990 CE, this is the highest resolution Holocene record from southern Africa and presents a unique opportunity for the detailed study of the primary drivers and spatial gradients of Holocene climate change in the southern Cape. The data indicate a long-term decrease in aridity across the Holocene and a pattern of variability that reveals remarkable similarities with records from the South African tropics and El Niño–Southern Oscillation proxies, highlighting the significance of tropical systems as drivers of Holocene climate change in the region. This substantially expands what has been previously considered to be the zone of tropical influence, extending from a coastal phenomenon associated with heat transport via the Agulhas Current to encompass much, if not all, of the Agulhas Plain south of the Cape Fold Mountains. These findings provide a valuable new climatic framework for contextualizing changes in ecological and archaeological records in the southern Cape, and contribute to a more comprehensive understanding of the spatio-temporal dynamics of climate systems in southern Africa. • Sub-decadal 9000-year record of aridity from South Africa's southern Cape. • Reveals dominance of tropical forcing across the southern Cape and Agulhas Plain. • ENSO variability indicated to be important driver of regional climate change. • Presents high-resolution framework for study of human-environment interactions. [ABSTRACT FROM AUTHOR]

This study explores the utility of the I-poem methodology to investigate subjective well-being in children and adolescents with ADHD in South Africa during the COVID-19 pandemic. Subjective well-being in this population has been studied extensively via quantitative methodologies. In addition, narrative studies, discourse and theme analysis, participatory and visual method studies have also contributed to deeper understandings in the field. The current study seeks to contribute to knowledge creation within this field of non-numerical studies in an attempt to decentralise the voice of researchers and highlight the voices of participants. In the I-poem methodology, self-report ratings of children and adolescents with ADHD between the ages of 10 and 18 years old (n = 376) during the COVID-19 pandemic in South Africa was captured in an open-ended question. Data was analysed through the researcher's creation of themed I-poems. The findings delineate broad categories of positive, negative and neutral feelings of subjective well-being during the pandemic. Notions of subjective well-being are related to themes of home, school, social life, self-growth and reflection, experiences of change, rules, extra-curricular activities, concerns, loss, finances, the new normal, and emotions. The study illustrates the utility of the I-poem methodology to illuminate dimensions of well-being that may otherwise remain invisible. The study also amplifies the potential of the I-poem methodology to be used in conjunction with, and complementary to, other research methodologies. [ABSTRACT FROM AUTHOR]

Adolescents and young adults (AYA) are identified as a high-risk group for HIV acquisition. However, health services are generally not sensitive to the needs of this priority population. In addition, multimorbidity (having more than one disease in an individual) is not well studied among AYA, as it is typically associated with older individuals. This paper reports on commonly co-occurring disease conditions and disease patterns in AYA, aged 15-24 years, who took part in the 2016 South African Demographic and Health Survey. Chi-squared tests and logistic regression were used to examine the weighted prevalence of disease among those with/without HIV, and the risk factors associated with HIV. Latent class analysis (LCA) was conducted to identify common co-occurring diseases. Of the 1787 individuals included in our analysis, the weighted prevalence of HIV was 8.7%. Hypertension (30.5%), anaemia (35.8%) and diabetes (2.0%) were more prevalent among those with HIV. HIV and anaemia, hypertension and anaemia, and HIV and hypertension comprise the largest disease burden of co-occurring diseases. Co-morbidity was high among those with HIV, emphasizing the need for integrated care of HIV and non-communicable diseases.

The recently released draft South African Ethics in Health Research Guidelines: Principles, Processes and Structures (Draft Guidelines) by the National Health Research Ethics Council recognize open data and provide guiding principles for this in the context of health research in South Africa. While its inclusion is a positive development, there is room for improvement. Although the Draft Guidelines leverage the Draft National Policy on Data and Cloud, it lacks incorporation of other relevant government policies, notably the Draft National Open Science Policy, and fails to sufficiently detail the principles of open science and open access. This limited scope and lack of comprehensive definition and detailed guidance present challenges for researchers in conducting ethical and responsible health research in South Africa. It constrains the Draft Guidelines from fully aligning with national imperatives and from fostering African-centric approaches. To address these issues, it is recommended that the Draft Guidelines integrate broader policies and principles, enhance clarity through comprehensive definitions, provide detailed guidance on open access, and promote African-centric approaches. Implementing these solutions will strengthen the Draft Guidelines, aligning them with national visions of open science, and thereby harnessing the full potential of South Africa's diverse scientific community in advancing health research. [ABSTRACT FROM AUTHOR]

Introduction: Despite the numerous efforts and initiatives, males with HIV are still less likely than women to receive HIV treatment. Across Sub-Saharan Africa, men are tested, linked, and retained in HIV care at lower rates than women, and South Africa is no exception. This is despite the introduction of the universal test-and-treat (UTT) prevention strategy anticipated to improve the uptake of HIV services. The aim of this study was to investigate linkage to and retention in care rates of an HIV-positive cohort of men in a high HIV prevalence rural district in KwaZulu-Natal province, South Africa. Methods: From January 2018 to July 2019, we conducted an observational cohort study in 18 primary health care institutions in the uThukela district. Patient-level survey and clinical data were collected at baseline, 4-months and 12-months, using isiZulu and English REDCap-based questionnaires. We verified data through TIER.Net, Rapid mortality survey (RMS), and the National Health Laboratory Service (NHLS) databases. Data were analyzed using STATA version 15.1, with confidence intervals and p-value of ≤0.05 considered statistically significant. Results: The study sample consisted of 343 male participants diagnosed with HIV and who reside in uThukela District. The median age was 33 years (interquartile range (IQR): 29–40), and more than half (56%; n = 193) were aged 18–34 years. Almost all participants (99.7%; n = 342) were Black African, with 84.5% (n = 290) being in a romantic relationship. The majority of participants (85%; n = 292) were linked to care within three months of follow-up. Short-term retention in care (≤ 12 months) was 46% (n = 132) among men who were linked to care within three months. Conclusion: While the implementation of the UTT strategy has had positive influence on improving linkage to care, men's access of HIV treatment remains inconsistent and may require additional innovative strategies. [ABSTRACT FROM AUTHOR]

Background: The publication of South Africa's National Mental Health Policy Framework and Strategic Plan 2023-2030 and the proposed National Health Insurance (NHI) make it timely to review that state of mental health services in the country, and to emphasize the importance of prioritising mental health as a pivotal component of holistic healthcare., Method: We searched the published literature on mental health using Google Scholar, Pubmed, and Bing Chat, focusing on these words: epidemiology of mental health disorders, depression and anxiety disorders, mental health services, mental health facilities, human resources, financing and impact of COVID-19 on mental health in South Africa and beyond. We also searched the grey literature on mental health policy that is publicly available on Google., Results: We provided information on the epidemiology and economic impact of mental health disorders, the availability of mental health services, enabling policies, human resources, financing, and the infrastructure for mental health service delivery in South Africa. We detail the high lifetime prevalence rates of common mental disorders, as well as the profound impact of socioeconomic determinants such as poverty, unemployment, and trauma on mental health disorders. We note the exacerbating effect of the COVID-19 pandemic, and emphasize the pressing need for a robust mental health care system., Conclusion: In addition to outlining the challenges, such as limited mental health service availability, a shortage of mental health professionals, and financial constraints, the review proposes potential solutions, including task-sharing, telehealth, and increasing the production of mental health professionals. The paper underscores the necessity of crafting a comprehensive NHI package of mental health services tailored to the local context. This envisioned package would focus on evidence-based interventions, early identification, and community-based care. By prioritising mental health and addressing its multifaceted challenges, South Africa can aspire to render accessible and equitable mental health services for all its citizens within the framework of the National Health Insurance., Competing Interests: Declaration of competing interest Prof.  Stein has received consultancy honoraria from Discovery Vitality, Johnson & Johnson, Kanna, L’Oreal, Lundbeck, Orion, Sanofi, Servier, Takeda and Vistagen., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: Currently, we have limited knowledge of any potential differences among patients with functional seizures (FS), otherwise known as psychogenic non-epileptic seizures (PNES), from different socioeconomic backgrounds. Investigating medication use among these patients may provide insight into the quality and intensity of medical care they receive. Thus, we aimed to assess and compare the frequency and quantity of antiseizure medications (ASMs), and psychiatric and other medications used among patients with FS from a private and public epilepsy monitoring units (EMUs) in Cape Town, South Africa., Methods: Only video-electroencephalographically (video-EEG) confirmed patients with FS with no comorbid epilepsy were eligible for the study. For this retrospective case-control study we collected data on patients' medication-taking histories using digital patient records, starting with the earliest available digital patient record for each hospital., Results: A total of 305 patients from a private hospital and 67 patients from a public hospital were included in the study (N = 372). Patients with FS attending the public hospital had lower odds of taking any ASMs at presentation (aOR=0.39, 95% CI [0.20, 0.75]) and ever taking psychiatric medications (aOR=0.41, 95% CI [0.22, 0.78]) compared to FS patients from the private hospital. They did, however, have higher odds of being discharged with an ASM (aOR=6.60, 95% CI [3.27, 13.35]) and ever taking cardiovascular medication (aOR=2.69, 95% CI [1.22, 5.90]) when compared to the private hospital patients. With every additional presenting ASM (aOR=0.63, 95% CI [0.45, 0.89]) and psychiatric medication (aOR=0.58, 95% CI [0.40, 0.84]) the odds of being from the public hospital decreased. However, they increased with every additional discharge ASM (aOR=3.63, 95% CI [2.30, 5.72]) and cardiovascular medication (aOR=1.26, 95% CI [1.02, 1.55])., Conclusion: Standard approaches to pharmacological treatment for patients with FS differed between the public and private hospitals and may indicate a gap in quality of care., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)