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South Africa has a documented high prevalence of stunting and increasing obesity in children as well as obesity in adults. The double burden of malnutrition, which can be on an individual‐, household‐ or population level, has implications for both health and the economic development of a community and country. This paper describes a large‐scale survey (N = 774) of infant feeding, growth monitoring and anthropometry among mother and child pairs aged 6 months of age in KwaZulu‐Natal (KZN), South Africa, conducted between January and August 2017. Among children, a large increase in the prevalence of stunting and obesity was seen between birth and 6 months of age increasing from 9.3% to 21.7% and 4.0% to 21.0%, respectively. 32.1% of the mothers were overweight [body mass index (BMI): 25.0–29.9] and 28.4% had obesity grade 1 (BMI: 30–<40). Although most mothers (93%; 563/605) initiated breastfeeding, the introduction of other foods started early with 17.6% (56/319) of the mothers having started giving other fluids or food to their child within the first month. At 6 months 70.6% (427/605) children were still breastfed and 23.5% were exclusively breastfed. In addition, we found that length measurements were done less frequently than weight measurements between birth and 6 months, on average 2.2 (SD: 1.3) versus 5.8 (SD: 1.5) times. Moreover, there is a need for improvement of health worker training and understanding regarding anthropometric measurements when assessing malnutrition in children in the clinics. Early detection and improved infant feeding practices are key in preventing both stunting and obesity in children. Key messages: The double burden of malnutrition is severe in KwaZulu‐Natal with high rates of maternal obesity and increasing prevalence of stunting and obesity among infants in the first 6 months of life.Breastfeeding and complementary feeding practices are suboptimal and additional support for breastfeeding is required in the post‐natal period and in the workplace to address breastfeeding challenges.Growth monitoring is inadequate in health facilities leading to many lost opportunities for early identification of malnutrition. Hence, anthropometric practices and interpretation of findings need to be strengthened. [ABSTRACT FROM AUTHOR]

This paper spotlights post‐disaster relief provision in Johannesburg, South Africa, following the floods of 2016 in a bid to explore how local government and non‐governmental actors in the country conceive of compounding vulnerability and conflict within urban disaster governance. It reveals the diverse strategies employed to navigate violent conflict during the cyclical occurrence of disaster and reconstruction that the predominantly migrant population experiences in the Setswetla informal settlement, adjacent to the Alexandra township in northern Johannesburg. Rendered visible in moments of disaster and recovery are the spatial politics and multidimensional nature of conflict. These phenomena unfold across various levels of urban governance and in the affected community and effectively construct a disaster citizenship that makes risk reduction and community cohesion impossible in the eyes of disaster managers. This research, based on a set of expert interviews, integrates conflict and disaster studies to shed light on how the conflict–disaster interface materialises, and is operationalised, in an urban setting. [ABSTRACT FROM AUTHOR]

Background: Critically ill patients have the right to communicate and participate in their treatment to avoid adverse medical outcomes due to the severity of their illness, their responsiveness, and level of consciousness. This human right has often been neglected by health care professionals, as a result of limited alternative communication support provided to patients who are unable to speak due to, for example, endotracheal intubation. Despite the successful use of alternative communication strategies in critical care units (CCUs) in other countries, limited implementation in South African hospitals has been reported. Aims and objectives: This study aimed to determine the perspectives of South African nurses working in CCUs on the frequency of use of alternative communication strategies to support patient‐centred communication with critically ill adult patients. Design: The study followed a quantitative non‐experimental survey research design. Methods: A total of 210 nurses working in both private and public hospitals completed a survey on their perspectives on the use of alternative communication strategies in CCUs. Results: Nurse participants reported experience working with critically ill and communication‐vulnerable patients. Nurse–patient communication mainly involved the use of pen and paper, facial expressions and gestures to obtain information relating to patients' needs and their health history. Limited use of speech‐generating communication devices was reported. Conclusion: Nurse training on the use and implementation of alternative communication strategies, such as communication boards or electronic speech‐generating devices, should be investigated to improve nurses' communication with communication‐vulnerable patients in South Africa. Relevance to clinical practice: The results are applicable in clinical practice due to patients' need for alternative communication. The nurses mainly used low‐tech solutions, which are cheap and easy to access. However, there exists an opportunity to increase the use of available digital solutions. [ABSTRACT FROM AUTHOR]

In South Africa, young men are generally considered to generate many of the risks associated with informal settlement life, yet their own vulnerability in these environments is seldom considered. Seeking insights into male susceptibility in these impoverished urban spaces is methodologically challenging. How does one encourage poor marginalised young men to speak with candour about their insecurities and challenges? The research methods used, while facilitating openness, should also build their confidence as they reflect on the challenges of everyday life. This paper describes the methodological journey undertaken in a study of young Black men living in informal settlements in Cape Town, South Africa, revealing how they perceive their vulnerability in these environments. It demonstrates how a suite of methods gradually developed through trial and error, with the young men themselves assisting in the adaptation of tools, ranging from interviews using adapted participatory methods to non‐prescriptive diary‐writing. Together they delivered deep and penetrating insights into the lives of the young men, and the nature of their vulnerability. [ABSTRACT FROM AUTHOR]

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

This paper challenges the claim, as articulated by Norman Ehterington, that the so‐called Great Trek was not "an act of national self‐assertion by Boers in rebellion against British rule" (2001:258). Whilst affirming the scholarly consensus that the Trek was not an expression of Afrikaner nationalism, I argue that it marked the rise of Boer nationalism, which entailed the transformation of white Dutch‐speaking farmers on the eastern border of the British‐ruled Cape Colony into ethnic Boers. The latter identity began to crystallise when the former was mobilised politically by a boer/Boer elite who anticipated their loss of power as colonial authorities introduced inconvenient policy changes and "alien" ideologies. Since the mid‐1830s, as I demonstrate, an ethnic consciousness started to develop among the leaders of the frontier farmers along with the idea‐the nationalist idea‐of a trek to self‐governance. If not as nationalism, I ask, how is one to interpret this cause for self‐governance, driven as many similar causes have been by both material and ideational forces? And how is one to interpret the trekkers' preoccupation with democratic state formation (however compromised it was by racism) while on trek and their eventual creation of the Republic of Natalia? [ABSTRACT FROM AUTHOR]

In post‐apartheid South Africa, migration policies and legislation have left critical issues such as social cohesion and integration unsolved. Furthermore, the inability to reconcile the national interest of maintaining borders' integrity with respecting moral and legal obligations has placed the asylum system under tremendous stress. Drawing from secondary sources, as well as qualitative interviews, this paper explores the development of new asylum policies aimed at curtailing asylum seekers' right to work in South Africa. The study's findings provide support for the conclusions of earlier research that highlights the consequences of hostile policies and practices for asylum seekers' livelihoods. The author argues that curtailments on asylum seekers' right to work will have many possible socio‐economic ramifications. In the immediate term, the legislation seeks to inhibit asylum seekers from engaging in self‐employment, while in the long run it may achieve the undesired effect of producing more precarious forms of livelihood. [ABSTRACT FROM AUTHOR]

The cave systems of the Malmani Dolomite, Gauteng, South Africa, have over the decades yielded numerous specimens of Pliocene to early Pleistocene hominin fossils which are critical for our understanding of human evolution. The geomorphological and geological context of these fossils is complex. An understanding of cave formational processes coupled with effective surface and subsurface mapping of different strata and soil depths has the potential to provide new insights. A technique that has not previously been employed to the fossil sites of South Africa is the use of ground‐penetrating radar (GPR). Applied in combination with ground‐truthing data from excavations and 3D scanning and photogrammetry the combined technique highlights the capacity for GPR to help characterise various deposits. Results indicate the potential of the method to identify new void spaces, depth of colluvium as well as mapping structurally important chert bedding. This paper focuses on the Paranthropus and early Homo‐bearing cave complex of Drimolen but highlights the potential for applying these methods throughout the region. [ABSTRACT FROM AUTHOR]

Background: As the prevalence of paediatric dysphagia increases, the need for long‐term non‐oral feeding has also increased. Despite these developments, little is known about caregiver experiences of transitioning a child onto long‐term non‐oral feeds, and the factors which influence the process of decision‐making and the provision of consent to do so. This paper aims to explore these factors. Methods: Semi‐structured interviews were conducted with nine participants recruited from the multidisciplinary out‐patient non‐oral feeding clinic at a hospital. Interviews explored caregiver experiences of decision‐making and the process of providing consent when transitioning their child to non‐oral feeds, as well as the support structures available to the caregivers. Interviews were audio recorded and transcribed, then analyzed using thematic analysis (Braun & Clarke, 2013) and content analysis (Neuendorf, 2016). Results: Challenges to care and quality of life, access to information and culturally relevant counselling, and the involvement of family members and significant others emerged as prominent themes. Findings suggest that quality of life was the most common motivating factor for transitioning a child to non‐oral feeding methods. Several participants suggested that support and information sharing via digital platforms were both useful and effective. Implications: The findings highlight caregivers' needs for improved access to information and social support. The findings hold implications for training of healthcare providers working in similar contexts and for models of service delivery which ensure that family‐centred intervention can be delivered in culturally and contextually relevant ways. With widespread access to smartphones, counselling should include digital messaging as a way of providing support and information sharing. Future research should focus on the complexities of counselling and the process of informed consent in settings impacted by diverse cultural, contextual and linguistic barriers, as well as the potential value of mobile health (mhealth) in ensuring improved health outcomes. [ABSTRACT FROM AUTHOR]

Rationale, aim and objective: The physiotherapy profession did not escape the effects of racially based segregatory practises. While numerous strategies and initiatives have been employed to redress the inequities of the past, the extent of demographic transformation within the physiotherapy profession in South Africa remains uncertain. Transformation is defined in this article as an intentional change aimed at addressing inequalities and the ultimate goal is for population group and gender profiles of higher education graduates to be representative of the national epidemiological profile. This paper describes the demographic patterns of Health Professions Council of South Africa (HPCSA) registered physiotherapists from 1938 to 2018. Method: A retrospective record review of the HPCSA database from 1938 until 2018 was performed. De‐identified data were extracted, coded and analyzed for descriptive purposes. Z‐tests were used for analysis of proportion differences, along with P‐values and 95% confidence intervals for interpretation. Results: In 2018, 7663 physiotherapists (6350 women and 1313 men) were registered with the HPCSA. Most registered physiotherapists (55.6%) were classified as white, followed by black (17.3%), coloured (10.3%) and Indian (9.8%). A progressive increase was found in the number of new registrations over time (1949‐2018) by black (0.00%‐24.38% of total new registrations), coloured (0.00%‐15.47%) and Indian individuals (0.00%‐10.03%), with a statistically significant increase in newly registered black therapists in the decade prior to 2018 (P =.005). Gender transformation appears to be occurring at a slower pace as the profession remains female‐dominated (82.9% of registered physiotherapists in 2018). Conclusion: There has been a steady transformation of the South African physiotherapy graduates composition regarding population categories and gender. However, it is clear that much more than selection criteria is needed to transform the profession in a way that is nationally representative, remain actively accountable for transformation and apt for local context. [ABSTRACT FROM AUTHOR]

The Permian–Triassic global crisis was the only event to have a dramatic impact on insect diversity, with Palaeozoic insect clades disappearing and accompanied by the accelerated rise of modern lineages. To date, most Permian palaeoentomological work has focused on the upper Permian deposits of the Normandien Formation (Beaufort Group), KwaZulu–Natal Province. This paper describes the regional insect fauna preserved close to the Permian–Triassic boundary at Wapadsberg Pass, southern Karoo Basin of South Africa, which provides a rare glimpse into insect life immediately before this global crisis. Here, we describe six insect species from six families within five orders from the two Wapadsberg Pass localities. Mioloptera stuckenbergi (Grylloblattodea) and Permocicada sp. (Hemiptera) were recorded previously from the Lopingian KwaZulu–Natal Province. In addition, we detail the first potential occurrence of South African Permian Tettigoniida (Orthoptera: Tettigonioidea & Hagloidea) and Anthracoptilidae (Paoliida). An Auchenorrhynchan (Hemiptera) nymph and an undetermined insect (order uncertain) also are described. [ABSTRACT FROM AUTHOR]

Industrialization and urbanization processes have challenged deeply held traditional gender norms and facilitated the emergence of modern ideologies in South Africa. This paper seeks to explore the gendered roles of family members on maternal and child nutrition and investigate indications of perceived change in related practices. A qualitative secondary analysis was conducted of data from nine focus group discussions (FGDs) held with men (n = 3) and women (n = 6) aged ≥18. Data from the FGD were coded and thematic analysis conducted. We found that elderly women seem to have a central advisory role with respect to maternal and child nutrition and that men and elderly women upheld patriarchal gender divisions of labour, which entrust mothers with the primarily responsibility for young children's nutrition. Young mothers relied on elderly women for provision of childcare and nutritious foods for children; however, they demonstrated some resistance to traditionally feminized forms of food preparation. We found that men's involvement in children's nutrition was limited, though they expressed a preference to be more involved in maternal and child nutrition and care practices. A gender transformative approach to policy development, which includes elderly women and men, has the potential to promote more gender‐equitable nutrition practices, increase young women's self‐efficacy and support them to overcome barriers that could be limiting their decision making power in achieving optimal nutrition for themselves and their children. [ABSTRACT FROM AUTHOR]